OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 5 — Questions and Answers
Question 1: During a surgical case, the scrub technician announces a break in sterile technique. The OT's immediate responsibility is to:
- Complete the current step before addressing the break to avoid disrupting workflow
- Stop the procedure, identify and correct the contamination, and replace any compromised items (Correct answer)
- Apply additional sterile drapes over the contaminated area and continue
- Notify the surgeon only if the break occurred on the patient side of the drape
Correct answer: Stop the procedure, identify and correct the contamination, and replace any compromised items
Any break in sterile technique must be immediately identified, communicated to the team, and corrected by replacing contaminated items before the procedure continues.
Question 2: Intraoperative cell salvage (autotransfusion) during major orthopaedic surgery is contraindicated when:
- The patient has a known bleeding disorder
- The surgical field is contaminated with infection or malignant cells (Correct answer)
- More than 500 mL of blood loss is anticipated
- The patient is over 65 years of age
Correct answer: The surgical field is contaminated with infection or malignant cells
Cell salvage is contraindicated if the surgical field is contaminated by infection or tumor cells, as reinfusing this blood could spread sepsis or malignancy.
Question 3: A surgeon requests a 'K-wire' during a percutaneous pinning procedure for a pediatric supracondylar humerus fracture. The OT should provide:
- A threaded Steinmann pin
- A smooth Kirschner wire of the surgeon's requested diameter loaded in a power drill (Correct answer)
- A cannulated screw guide wire
- A flexible reamer wire
Correct answer: A smooth Kirschner wire of the surgeon's requested diameter loaded in a power drill
K-wires (Kirschner wires) are smooth, small-diameter stainless steel wires that are driven percutaneously with a power drill to temporarily stabilize pediatric fractures.
Question 4: Which measurement is most critical for the OT to verify and document when applying a fiberglass cast after surgical fracture fixation?
- Ambient room temperature at time of application
- Capillary refill, sensation, and motor function distal to the cast before and after application (Correct answer)
- The color of the stockinette under the cast padding
- Cast weight compared to manufacturer specifications
Correct answer: Capillary refill, sensation, and motor function distal to the cast before and after application
Neurovascular status (capillary refill, sensation, and movement) distal to the cast must be assessed and documented before and after application to detect compartment syndrome or nerve compromise.
Question 5: When handling a retrieved orthopaedic implant that has been removed during a revision surgery, the OT should:
- Discard it in the surgical waste bin immediately after removal
- Clean and re-sterilize it for potential reuse in the same patient
- Place it in a labeled specimen container, document it, and give it to the circulating nurse per protocol (Correct answer)
- Return it to the sterile field in case the surgeon needs to reference it
Correct answer: Place it in a labeled specimen container, document it, and give it to the circulating nurse per protocol
Explanted implants are placed in a labeled container, documented (including lot/serial numbers), and processed per institutional protocol, which may include sending for laboratory analysis or returning to the patient.
Question 6: During an acetabular cup impaction in a total hip arthroplasty, the OT's role when the surgeon uses the acetabular cup impactor and mallet is to:
- Strike the mallet while the surgeon guides the impactor for two-person accuracy
- Maintain stable patient positioning and alert the surgeon if the limb moves unexpectedly (Correct answer)
- Count mallet strikes and record them in the operative note
- Apply counter-pressure on the iliac crest to stabilize the pelvis during impaction
Correct answer: Maintain stable patient positioning and alert the surgeon if the limb moves unexpectedly
The OT maintains the patient in a stable lateral position and monitors for movement during impaction forces, alerting the surgeon to any positional changes that could affect cup orientation.
Question 7: The 'time out' procedure performed immediately before an orthopaedic incision is designed to confirm which set of critical data?
- Patient identity, procedure, surgical site/side, consent, and implant availability (Correct answer)
- Anesthesia drug doses and patient weight
- Instrument count and tourniquet pressure only
- Surgeon credentials and OR scheduling accuracy
Correct answer: Patient identity, procedure, surgical site/side, consent, and implant availability
The pre-incision time out verifies patient identity, the planned procedure, correct surgical site and laterality, consent status, and readiness of required implants per JCAHO Universal Protocol.
OTC Orthopaedic Technologist Certified Surgical Procedure Assistance 5
During a surgical case, the scrub technician announces a break in sterile technique.
The OT's immediate responsibility is to: