Anesthesia and Patient Safety in the OR Flashcards

Which surgical positioning complication is most associated with the lithotomy position?

Answer: Compartment syndrome of the lower legs and common peroneal nerve palsy

Prolonged lithotomy position compresses the common peroneal nerve at the fibular head against the stirrups and restricts calf perfusion, leading to compartment syndrome and peroneal nerve palsy.

Intraoperative hypothermia (core temperature < 36°C) increases the risk of which complication most significantly?

Answer: Surgical site infection and coagulopathy

Hypothermia impairs neutrophil oxidative killing, causes vasoconstriction reducing tissue oxygenation, and inhibits coagulation enzyme function, tripling SSI risk and promoting coagulopathy.

The CRNFA should count surgical sponges, sharps, and instruments at which standardized time points?

Answer: Before the procedure, before closure of a body cavity, before skin closure, and at time of relief of any team member

AORN standards require four standardized count times: initial count, before body cavity closure, before wound closure, and at personnel relief — to prevent retained surgical items.

A fire has started on the sterile drape from an ESU spark near supplemental oxygen. The CRNFA's immediate priority is to:

Answer: Remove the burning drape from the patient, stop oxygen flow, and extinguish the fire away from the patient

The RACE/PASS OR fire response prioritizes removing the burning material from the patient and cutting off the oxygen supply (the oxidizer) before using an extinguisher away from the patient's airway.

Which element of the WHO Surgical Safety Checklist is performed immediately before skin incision and requires ALL team members to stop and verbally confirm?

Answer: Time-out (before skin incision)

The Time-Out is performed immediately before incision with all team members actively confirming patient identity, site, procedure, team introductions, and critical concerns.

When the CRNFA notes that the ESU active electrode is in contact with a retractor touching a different tissue plane than intended, which hazard is present?

Answer: Alternate site burn (direct coupling) through the unintended tissue contact

Direct coupling occurs when the active electrode inadvertently contacts a metal retractor or other conductor, allowing current to flow to and burn unintended tissue far from the operative site.