Question

Surgical Technology program
Case study: Sue is the CST working on call, and she is called in for an emergency craniotomy for a 28 year old man who presented to the emergency room with a head injury. His history indicates he is morbidly obese and smokes but otherwise seemed fine until today. His friends stated that he became confused and then fell off the balcony when he lost his balance. He fell two stories onto a cement parking lot. The physician schedule a craniotomy and evacuation subdural hematoma with insertion of ICP monitor.

                   Questions
Q1. As Sue opens her supplies, she notes that there is an expiration date on several items, if sterilization is event related, why would there be an explanation date on some items?

Q2. Because he has a significant scalp would laceration but a closed head injury, what factors may predispose his case for an SSI? As the surgeon enters the room, he states that he just spoke with the family, and there is a history of CJD. What changes will Sue make for the setup?

Q3. If Sue uses the regular setup, what possible impact could this have on the next patient?

Answer 1

1) Reusable medical devices are sterilized by commercial manufacturers or sterilizing departments located in hospitals. Commercial manufacturers allocate expiry dates on sterilized items which should be respected, unless sterility is compromised by an event. Means the item got from the market are sterlized we can use them before the expiratory date after that we can use them by doing self sterilization

2)  The factors that predispose this case for surgical site infection are Obesity , uncleaned wound etc. This can be prevented by Cleaning and removing foreign material. early closure of wound is necessary to prevent infection. Make the wound to be short.

Creutzfeldt-Jakob disease (CJD) is the most common human form of a group of rare, fatal brain disorders known as prion diseases.The change in the setup include reprocess heat-resistant instruments that come in contact with tissues of patients with suspected or confirmed CJD, proper sterilization of instruments , sterilization of floor etc

3) Iatrogenic transmission of the CJD agent can occur in the next pt with the infected surgical instruments