Introduction to SUR 111 Perioperative Patient Care

1. Introduction to SUR 111Perioperative Patient Care

2. Microbiology • The study of microorganisms • Microorganisms are life forms that cannot be seen with the naked eye • Determining life: • Able to reproduce • Ingest and metabolize food • Eliminate waste • Irritable (respond to stimuli) • Able to mutate or change genetic make up

3. Taxonomy(Classification) • Kingdoms • Animal • Plant • Protista (protozoans) • Fungi ________________________ • Monera (bacteria) (Eucaryotic cells) (Procaryotic cells)

4. VIRUSES (Virion) ONE MORE THING: • Neither Procaryotic or Eucaryotic • Arguable as to whether or not these are life forms as they do not display the five characteristics of life • Are obligate intracellular parasites • Means reproduction dependant on a cell host • There are viruses that can infect or live in a bacteria: Bacteriophages • Smallest microorganism • (need an electron microscope to see) • This is a viron!

5. Bacteriophages

6. Eucaryotic You, You, You! are composed of eucaryotic cells! Have a true nucleus Have a nuclear membrane Chromosome encapsulated More advanced Procaryotic Bacteria in this class No nuclear membrane Chromosome floats in cytoplasm Eucaryotic verses Procaryotic

7. Our Focus Viruses & Bacteria

8. BACTERIA

9. Genus First letter of capitalized Italicized or underlined May see abbreviated capital letter/period Example: E. for Escherichia Species All lower cased Italicized or underlined Example: coli Bionomical System of Nomenclature(Scientific Name) Correct forms: Escherichia coli or E. Coli or Escherichia coli or E. Coli

10. Standard Equipment Capsule Slime layer Outer covering Protection Movement (like slugs) Cell membrane Regulation of things moving in and out of cell DNA (1 chromosome) Reproduction Called binary fission Optional equipment Cell Wall Protection Morphology (shape) Peptidoglycan protein determines staining (gram positive or gram negative) Flagella Movement Pili Attachment Endospores (spores) For Ultimate hibernation Survival mechanism Procaryotic Cell Structure

11. Gram Positive Turns slide purple Thick peptidoglycan layer stabilized by techoic acid Allows staining agent to permeate and stay visible Gram Negative Turns red/pink Thin peptidoglycan layer Doesn’t absorb staining agent Identifying Bacteria

12. Gram Positive • Gram Negative

13. Identifying Bacteria Gram Indeterminate Do not stain because they have no cell wall

14. Morphology(Shape of Bacteria) Bacillus (bacilli) Rod shaped Coccus (cocci) Round or circular Are other shapes you’ll learn in microbiology course: Vibrio curved Spirillium (2 curves) ~ Spirochete (many curves) w Coccobacillus (football shape)

15. Morphology Continued • Are bacteria with no cell wall (remember gram indeterminate?) • Shape is undefined as a result of no cell wall and are referred to as polymorphic or pleomorphic in shape • Polymorphic or pleomorphic just means these bacteria can occur in many different shapes

16. FOCUS Cocci Bacilli Arrangement determined by how they split (reproduction) Splitting in two = Binary Fission Arrangements of Bacteria (How they connect to one another)

17. Cocci Strepto = chain Above = Streptococci Staphylo = cluster Above = Staphylococci

18. Other Arrangements for Cocci Diplococci Tetracocci

19. Bacilli Steptobacillus Strepto = chain

20. Physiology • Temperature Ranges • Gas Requirements • Fragility • Hardiness • Fastidious • Carbon sources • Energy sources

21. Gas Requirements • Aerobic • Must have oxygen to survive • Anaerobic • Must have carbon dioxide to live • Strict Anaerobes • Placed in oxygen, will die • Facultative • Can tolerate both conditions

22. Fragility • Fragile bacteria are: • Easily destroyed • Do not live outside their normal environment

23. Hardiness • Hardy bacteria: • Tolerate many environments • Likely are spore producers • Difficult to destroy

24. Fastidious • Fastidious bacteria: • Have strict growth requirements • Grow well under certain conditions

25. Sterilization • Microorganisms must be removed from anything that is to be used inside the human body prior to surgical procedures • Sterilization is the term used to describe the absence of all microorganisms including spores

26. Factors in Achieving Sterilization • Types of sterilization • Various methods • Method of dependent upon item being sterilized • Considerations with sterilization • Monitoring successful sterilization • Physical indicators • Chemical indicators • Biological indicators • Will cover in depth within coming weeks

27. Roles in Surgery • Sterile team members • Nonsterile team members • Surgical technologists are sterile team members however they may function in a nonsterile role • Surgical technologist are an integral part of the surgical team

28. Only sterile items are used in the sterile field A sterile barrier must be considered contaminated after it has been penetrated Edges of a sterile package or container are considered contaminated after it has been opened Gowns are considered sterile only from nipple level to the lowest horizontal surface and the sleeves to two inches above the elbow Only horizontal surface of a table is considered sterile Sterile persons or items touch only sterile areas. Nonsterile persons or items only touch nonsterile areas. Movement in and around the sterile field must not compromise or contaminate that field All items and areas of doubtful sterility must be considered contaminated. When in doubt, throw it out! Principles of Asepsis

29. Surgical Attire • Personal hygiene observed • No jewelry, nails trimmed and clean (not over fingertips, no nail polish, no cuts/abrasions/rashes on skin • Scrubs with strings tucked • Hair covered (long hair tied back and covered) • Foot covers (booties)

30. PPE (personal protective equipment) • Hair cover • Shoe covers (removed prior to leaving OR department) • Mask (worn properly in restricted areas and removed at proper times) • Sterile Gown • Sterile Gloves • Clean Gloves (worn when doing nonsterile activities)

31. Where Do I Wear Various Articles of Surgical Attire? • Must understand OR Traffic Patterns • Unrestricted • Semi-restricted • Restricted • Some facilities do not have a semi-restricted area, only unrestricted and restricted

32. Let’s practice and begin recognizing our Surgical Attire and where to wear it