#13951 - Osce Stations - Veterinary Practical Techniques

Scrubbing up:

• Open sterile brush packet.

• Adjust taps to suitable flow and temperature

• Wash hands thoroughly three times – first time work up to elbow, second to arm/wrist and third just hands. Rinse keeping hands above elbows at all times. Remember to use elbow and not hand to dispense soap.

• Apply scrub to brush and scrub palms of the hands, all four surfaces of the fingers and thumb and under the nails. 10 brush strokes per surface.

• Rinse again keeping hands above elbows.

• Wash hands once more and rinse.

• Dry using a sterile towel. Use one corner for each hand, and one corner for each arm. Dry arm by starting at wrist and twisting down – do not move towel back up arm.

• If you contaminate yourself at any point – by touching something or when drying your arms, you must state this and start again.

Gowning:

• Assistant needs to pull bag down so you can pick up the gown by the shoulder seams.

• Shake the gown out – be careful it does not touch anything, stand in an open space.

• Put arms through but do not put hands outside of the cuffs.

• Assistant will tie you in.

• Hold out waist ties for assistant to tie.

Closed gloving:

• After putting on surgical gown, lay out glove packet with fingers pointing towards you.

• Pick up the cuff of the right hand glove (on the left) through the cuff of the gown.

• Elevate the glove and rotate arm so that the glove is lying on the top of your arm with the fingers pointing towards you.

• Use your left hand inside the cuff of the gown to grasp the edge of the cuff of the glove and pull it up and over your right hand.

• Extend your right hand through the cuff of the gown and into the glove. It doesn’t matter if your hand does not fit properly into the glove as you can adjust this once your other glove is on.

• Then pick up the cuff of the left hand glove (on the right) with your hand still in the cuff of your gown.

• Use your right hand to pull the cuff over your left hand – you can slide your thumb underneath the folded cuff of the glove as this is now sterile.

• Extend your left hand through the cuff of the gown and into the glove.

• You can now adjust the fit of the gloves using both hands.

Open gloving:

• Open glove packet without touching the inside of the packet and with the fingers of the gloves facing away from you.

• Pick up the cuff of the right hand glove (will be on the right) with your left hand.

• Slide your right hand into the glove and tuck your thumb inside the cuff of the glove – don’t pull glove right over thumb.

• Slide your right hand inside the cuff of the left glove to pick it up.

• Slide your left hand inside the glove. Use your right hand tucked under the cuff to pull the glove over your left hand.

• Slide the fingers of your left hand inside the cuff of your right glove (which is over your right thumb) to pull the cuff up your right arm.

Surgical site preparation:

• Site is clipped neatly – thick, long hair clipped in same direction as coat, then short hair against direction of coat with blade flat against skin. Use size 40 clipper blade.

• Vacuum away clipped hair.

• Prepare bowl of surgical scrub solution and swabs.

• Clean from inside outwards in increasing circular movements. Discard swab at the end and repeat with clean swab until the area is clean.

• Rinse with surgical spirit.

Abdominal draping:

• Hold the drape by two corners and allow it to fall open – make sure it does not touch anything, stand back from the patient to do this.

• Fold over the top edge of the drape.

• Rotate the top edge of the drape so that your hands are enclosed within the drape.

• Place the first drape closest to the sterile person.

• Then place the cranial or caudal drape. Secure with a towel clip.

• Place the third drape and secure with a towel clip.

• Walk around the table to place the last drape.

Limb draping:

• The prepared and scrubbed limb should be elevated by a tie secured to a drip stand or by an unsterile person holding the limb.

• Use the same method of folding over the top of the drape and rotating hands to be in the drape.

• Place the first drape over the lower limb.

• Hold a drape below the limb. The limb is then released onto the drape and the drape wrapped around the limb and secured with a towel clip.

• A further drape is placed on the caudal and cranial aspects of the patient.

• The last drape is placed by walking around the table.

Place and stabilise IV catheter:

• Prepare all equipment – IV catheter, bung, lengths of tape.

• Prepare the site with surgical spirit.

• Grasp the limb and palpate the vein. Place your thumb alongside the vein to stabilise it.

• Insert the catheter bevel up at an angle of around 30 degrees. Be careful not to touch the white part of the catheter. Only insert the catheter shallowly at first.

• When blood is seen in the hub of the needle, lower the catheter and advance.

• Once the catheter is in place, grasp the hub of the needle between index finger and thumb. Push the stylet off rather than pulling the needle out.

• DO NOT re-insert stylet whilst the catheter is in the limb.

• Attach a bung.

• Secure the catheter with tape. Place one piece of tape under the catheter and wrap around. Place a second piece of tape...