Veterinary Surgical Nursing

1
Veterinary Surgical Nursing

• INSTRUMENT MAINTENANCE

2
Sharps !

• Be aware of sharp instruments such as scissors,
  scalpel blades and needles
• Use haemostats or needle holders to remove
  scalpels
• Place into sharps container

3
Allergies ?

• Some of the cleaning preparations may cause skin
  allergies.

4
For Your Protection

• Make sure you are wearing suitable protective
  clothing
• rubber gloves
• plastic aprons

5
Careful handling

• Most instruments are delicate and should be
  handled carefully
• Instrument use should suit the purpose
• Try to preserve sharp edges

6
Sort

• Remove all opened surgical packs and contaminated
  equipment for cleaning.
• Sort all instruments prior to washing to avoid
  damaging the finer instruments with the heavier
  ones.

7
Open

• Before cleaning make sure that the ratchets
  (closing devices) on the instruments which have
  them are open.

8
Rinse

• Rinse instruments and drapes especially if
  cleaning is to be delayed.

9
Cleaning Methods

1. Water scrubbing only
2. Water scrubbing followed by detergent soak
3. Water scrubbing followed by ultrasound

10
Water Scrubbing

• Dont use hot water coagulates proteins
• Use cool or warm running water
• Dont clean with saline corrodes

11
Water Scrubbing

• Use a toothbrush or scrubbing brush to remove
  debris
• fine grooves and serrations
• between the hinges, ratchets and box-joints
• Avoid abrasive scrubbers (steel wool)

12
(No Transcript)
13
Detergent Soaking

• If using a detergent
• Use only commercially prepared instrument
  detergents
• Rapidex can (can also use in Ultrasound
  cleaning, also disinfectant proprties)
• Pyroneg
• Ordinary soaps can precipitate onto instruments
  as an alkali film dont use

14
Ultrasound Cleaning

• Used by some practices
• Does not sterilise
• but very effective in removing debris especially
  in the difficult to access parts such as the
  hinges.
• The ultrasonic cleaning process is called
  cavitation
• Vibrations Instrument detergent gt bubbles
  collapse and reform many thousands of times per
  second on the surface of the instruments causing
  a scrubbing action by which the debris is
  removed.
• Usually 10 mins enough

15
Ultrasound Basin
16
Ultrasound Detergent
17
Final Rinsing and Drying

• After cleaning instruments can be rinsed in hot
  water and left open on a flat surface to dry.
• But, if then using instrument milk do not rinse
  off this milk

18
Air machines

• Orthopaedic drill
• Wipe with disinfectant cleaner
• Do not immerse
• Lubricate as per instruments instructions

19
Inspection

• Check the alignment and angle of the jaws of
  instruments.
• Scissors become blunt with use and the
  veterinarian will generally alert you to this so
  that they can be put aside for sharpening.
• Suture needles also become blunt and their tips
  can become bent over.

20
Inspection (contd)

• Check the stiffness of hinges
• Suture needles also become blunt and their tips
  can become bent over.

21
Inspection (contd)

• Check sharp instruments for nicks or burs
• Check screws and pins for snugness
• Check that needle holders will hold a needle
  without rotating

22
Inspection (contd)

• Check that ratchets dont easily spring open when
  instrument lightly tapped
• Check tips of towel clamps for bending

23
Protection

• After cleaning, instruments may be immersed for a
  short time in a commercially available instrument
  milk which provides
• Lubrication
• Corrosion protection

24
Protection

• Instrument milk
• An emulsion of water and oil that does not
  interfere with sterilisation
• 30 seconds enough
• Wear gloves
• Allow to drain
• Dont rinse off
• Anti-rust (sodium nitrite)

25
Lubrication

• Dont use mineral oil or grease !
• An oily film traps and protects bacteria from
  steam sterilisation

26
Storage

• If they are not to be resterilised they should be
  stored in a dry place
• Leave ratchets open or on the first notch.
• Storage of instruments with their ratchets fully
  closed will eventually lead to metal fatigue and
  loss of function.

27
The End