Your FREE CST Flashcards 2026 – 200+ Cards

A pause before incision where the whole team verifies correct patient, correct procedure, and correct site/side to prevent wrong-site surgery.

Mechanically and chemically removes soil and transient microbes and reduces resident flora on the hands and forearms before gowning and gloving.

Two accepted surgical scrub methods: a counted number of brush strokes per finger/surface, or a timed scrub (typically 2–5 minutes per facility policy).

Keep hands above the elbows during and after the scrub so water runs from the cleanest area (fingertips) down toward the elbows.

The preferred self-gloving method: hands stay inside the gown sleeves/cuffs while pulling on gloves, so bare skin never touches the glove's outside.

Gloving where fingers protrude through the cuffs; used for procedures not requiring a full gown (e.g., Foley insertion) or to change a single glove.

Prep from the incision site outward in expanding circles toward the periphery — clean to dirty — and never return a used sponge to the center.

Chlorhexidine gluconate (CHG), povidone-iodine (Betadine), and alcohol-based preps; CHG has longer residual activity.

Alcohol-based preps pooling under drapes are a fire hazard and can cause skin burns; allow full drying before draping/electrosurgery.

Remove hair only if it interferes with the procedure, using clippers (not a razor) immediately before surgery to reduce skin-nick infection risk.

Verify the patient with at least two identifiers (name + date of birth), the consent, the procedure, and the surgical site/side.

Lying flat on the back; the most common surgical position, used for abdominal, cardiac, and many general procedures.

Supine with the head lower than the feet; used for lower-abdominal/pelvic surgery to shift bowel cephalad. Watch for respiratory compromise.

Supine with the head higher than the feet; used for upper-abdominal, head/neck, and thyroid surgery.

Supine with legs raised and abducted in stirrups; used for gynecologic, urologic, and rectal procedures. Raise/lower both legs together.

Lying face down; used for spine and posterior procedures. Protect the eyes, face, breasts, and genitalia, and support the chest.

Lying on one side; used for kidney, hip, and thoracic procedures. Place an axillary roll to protect the brachial plexus.

Sitting/semi-sitting; used for some cranial, shoulder, and nasopharyngeal procedures. Risk of venous air embolism.

Pad bony prominences and nerves, maintain body alignment, avoid pressure on the eyes and genitalia, and protect the brachial plexus and peroneal nerve.

The common peroneal nerve (from stirrup pressure at the lateral knee/fibular head), causing foot drop.

A restraint placed ~2 inches above the knees on the supine patient to prevent falls; never so tight it impairs circulation.

An indwelling urinary catheter drains and measures urine during long procedures; inserted with sterile technique to prevent CAUTI.

A tube from nose to stomach to decompress the GI tract or remove contents; used in many abdominal procedures.

An area created with sterile drapes and supplies around the surgical site; only sterile items and sterile-gowned/gloved persons may contact it.

The absence of pathogenic microorganisms. Surgical (sterile) asepsis aims for the total absence of all microbes on the sterile field.

The professional honesty and self-discipline to maintain sterile technique and report any break in sterility, even when no one else sees it.

Only sterile items may touch other sterile items. If a sterile item contacts anything unsterile, it is contaminated.

The outer 1 inch around the edge of a sterile drape or wrapper is considered unsterile (the boundary zone).

A sterile gown is sterile only from the chest/nipple line to the level of the sterile field (waist) in front, and the sleeves from 2 inches above the elbow to the cuff.

Anything below the waist/table level or out of sight is considered unsterile; the sterile field is only chest-to-waist height.

Moisture wicking through a drape, gown, or wrapper that carries microbes from an unsterile surface to a sterile one, contaminating it.

The CST who maintains the sterile field, sets up the back table/Mayo, passes instruments, and tracks counts during the procedure.

The RN/team member outside the sterile field who manages the room, obtains supplies, documents, and assists with counts and patient care.

A small sterile stand placed over the patient holding the instruments in immediate use during the procedure.

The large sterile table holding the bulk of the instruments, sponges, sutures, and supplies organized by the scrub.

Sponges, sharps, and instruments are counted by the scrub and circulator before the procedure (baseline), and recorded.

Before the procedure (initial), before closure of a cavity, before wound (skin) closure, and whenever staff is relieved — plus any time counts are in question.

Notify the surgeon, recount, search the field/floor/trash/drapes, and obtain an X-ray if the item is not found; document everything.

Surgical sponges contain a radiopaque marker so a retained sponge shows up on X-ray; never use them as dressings.

A 'never event' — an item (sponge, needle, instrument) unintentionally left in the patient; counts exist to prevent it.

A designated tray or magnetic mat for passing sharps hands-free between scrub and surgeon to prevent sharps injuries.

A #3 handle takes #10, #11, #12, and #15 blades; a #4 handle takes the larger #20–#23 blades.

#10 = a large curved belly for long skin incisions; #15 = a small curved blade for short, precise incisions.

A sharp, pointed (stab) blade used for incising abscesses, making arteriotomy/stab incisions.

Use a needle holder (not fingers), grasp the dull (non-cutting) edge, and slide the blade onto the handle's groove pointing away from yourself.

Scalpels, Mayo scissors (heavy/suture), Metzenbaum scissors (delicate tissue), and bandage scissors.

Mayo = heavier, for cutting suture and dense tissue; Metzenbaum ('Metz') = lighter and longer, for fine/delicate tissue dissection.

Forceps (thumb/pickups), Allis, Babcock, Kocher (Ochsner), and tenacula — used to hold or retract tissue.

Allis = teeth that grasp tissue firmly (e.g., to be removed); Babcock = atraumatic, rounded ends for delicate/tubular structures like bowel.

Hemostats (mosquito, Crile, Kelly), Rochester-Pean, and right-angle (Mixter) clamps used to clamp bleeding vessels.

Mosquito = smallest, fine bleeders; Crile = fully serrated jaws; Kelly = partially serrated jaws; size increases mosquito < Crile/Kelly < Pean.

An instrument that grasps and drives a curved suture needle; load the needle 1/2 to 2/3 from the tip, in the holder's jaw tip.

Handheld (Army-Navy, Richardson, Deaver, malleable) held by an assistant; self-retaining (Weitlaner, Balfour, Bookwalter) hold themselves open.

Probes, grooved directors, and dilators (e.g., Hegar, Bakes) used to explore or enlarge a structure or duct.

Yankauer (tonsil) for the oropharynx/large volumes; Poole (with guard) for abdominal cavities; Frazier for delicate neuro/ENT fields.

Pass firmly into the surgeon's palm in the ready-to-use position so they need not look away from the field; pass curved instruments curve-down.

The interlocking teeth on the finger rings of a clamp/needle holder that lock the jaws closed at set tensions.

The grooves on instrument jaws that improve grip on tissue or suture; transverse, longitudinal, or cross-hatched.

Toothed (rat-tooth/Adson) grip skin/tough tissue; smooth/non-toothed forceps handle delicate tissue (bowel, vessels) atraumatically.

A ring forceps holding a folded sponge, used for prepping, blunt dissection, or absorbing fluid in a deep cavity.

Surgical gut (plain/chromic), polyglactin 910 (Vicryl), poliglecaprone (Monocryl), polydioxanone (PDS) — broken down by the body over time.

Silk, nylon (Ethilon), polypropylene (Prolene), polyester, and stainless steel — remain or are removed; used where lasting strength is needed.

The more zeros, the smaller the suture: 2-0 is larger than 5-0; sizes range from heavy (#5) down to very fine (11-0).

Monofilament = single strand, less tissue drag and lower infection harbor; multifilament (braided) = stronger handling but more capillarity.

A strand of suture used to tie off (ligate) a blood vessel; a 'free tie' is handed without a needle; a 'tie on a passer' is on a clamp.

A suture permanently attached to the needle (no eye), so a single strand passes through tissue — atraumatic.

Cutting needles (sharp edges) for tough tissue like skin/fascia; tapered (round body) needles for soft tissue like bowel and vessels.

Devices that place rows of staples for skin closure, GI anastomosis (GIA/TA/EEA), and ligation — faster than hand-suturing.

Raytec (4-by-4-inch, radiopaque), laparotomy ('lap') sponges, Kittner/peanut dissectors, and cottonoids (neuro) — all counted.

Uses high-frequency current to cut tissue and coagulate (stop) bleeding; cutting = continuous current, coagulation = intermittent.

Monopolar = current flows from the active electrode through the patient to a dispersive (grounding) pad; bipolar = current passes only between the two forceps tips (no pad).

Place over clean, dry, well-vascularized muscle close to the site; avoid bony prominences, scars, implants, and hair to prevent burns.

Electrosurgery/laser smoke can carry viable cells, viral DNA, and toxins; use a smoke evacuator and high-filtration masks.

Creates a bloodless field on an extremity; record inflation pressure and time, and limit time (often up to 60 min upper / 90 min lower limb) to avoid nerve/tissue injury.

The amount of blood lost during surgery, estimated by weighing sponges, measuring suction canisters, and observing drapes.

Gelfoam, Surgicel (oxidized cellulose), thrombin, bone wax, and microfibrillar collagen — promote clotting at the bleeding site.

Identify, keep correct (often do NOT place gross specimens in formalin until verified), label with patient/site, and hand off to the circulator promptly; never let a specimen dry out unless ordered.

A specimen sent fresh (NOT in formalin) for rapid pathology while the patient is still under anesthesia to guide the procedure.

Specimens for culture and sensitivity are placed in the appropriate sterile container/medium (aerobic/anaerobic), not formalin.

Minimally invasive surgery through small ports using a camera (laparoscope) and long instruments; the abdomen is insufflated with CO₂.

Carbon dioxide is noncombustible, highly soluble in blood (so emboli are rare), and inexpensive — used to create pneumoperitoneum.

Veress needle = closed insufflation entry; Hasson (open) technique = direct visualized port placement; both establish pneumoperitoneum.

A sharp/blunt-tipped instrument within a cannula used to puncture the body wall and create a port for laparoscopic instruments.

An endoscope views a hollow organ/cavity through a natural orifice; a laparoscope is the scope used through ports for abdominal MIS.

Sets up sterile instrument arms, drapes the robotic arms, exchanges instruments, and assists at the bedside while the surgeon operates from a console.

Wear wavelength-specific eye protection, post warning signs, cover windows, use non-reflective instruments, keep water/saline ready, and protect the airway from ignition.

Wear lead aprons/thyroid shields, increase distance from the source, and minimize exposure time (time, distance, shielding).

Pressure, ligatures, suture ligation, clips, staples, bone wax, and tourniquet — physical means to stop bleeding.

Electrosurgery, laser, argon beam coagulation, and harmonic (ultrasonic) scalpel — use energy to coagulate tissue.

Class I — Clean: uninfected, no inflammation, respiratory/GI/GU/oropharyngeal tracts not entered (e.g., a hernia repair).

Class II — Clean-contaminated: a controlled entry into the respiratory/GI/GU tract without unusual contamination (e.g., elective cholecystectomy).

Class III — Contaminated: open fresh wounds, major break in sterile technique, or gross GI spillage.

Class IV — Dirty/infected: old traumatic wounds with retained devitalized tissue, or existing clinical infection/perforated viscera.

Maintain sterile technique, give timely prophylactic antibiotics, normothermia, glucose control, proper hair removal (clippers), and skin antisepsis.

Fuel (drapes, alcohol prep, hair), oxygen (O₂-enriched field), and ignition (ESU, laser) — control all three to prevent OR fires.

Aseptic technique = practices that reduce contamination broadly; sterile technique = the strict practices that keep a defined field free of all microbes.

Open the far flap first, then the sides, then the near flap toward yourself; never reach over the sterile field or turn your back to it.

The circulator pours from the edge into a basin held by the scrub (or at the field's edge) without splashing or reaching over the field.

Keep sterile setups continuously monitored; an unattended or covered field is considered contaminated.

Apply drapes from the incision site outward; once placed, do not move drapes toward the field — only away — and never reposition a dropped drape.

Rising heart rate, falling blood pressure, increasing blood in suction/sponges, and a tense/expanding field — alert the surgeon and prepare hemostatic supplies.

If the electrosurgical unit alarms or won't activate, check the dispersive pad contact and connections before increasing power, to avoid burns.

Drains evacuate blood/fluid from a wound; Penrose = passive; Jackson-Pratt and Hemovac = closed active (suction) systems.

Primary union: a clean incision with edges approximated (sutured); heals fastest with minimal scarring.

The wound is left open to heal by granulation from the bottom up (e.g., infected/contaminated wounds); more scarring.

A contaminated wound is left open, then sutured/closed after several days once infection risk decreases.

Dehiscence = partial or total separation of wound layers; evisceration = protrusion of viscera (e.g., bowel) through the open wound — an emergency.

Protect the wound, absorb drainage, apply pressure/support, maintain a moist healing environment, and provide a barrier to contamination.

Perform the final counts, hand off the specimen, account for sharps, apply the dressing after the drape is removed, and break down the field safely.

Where the patient recovers from anesthesia and is monitored (airway, vitals, level of consciousness) before discharge to a unit or home.

After the dressing is on, keep gown/gloves until the patient leaves; dispose of sharps in puncture-proof containers and handle instruments to prevent injury.

A life-threatening reaction to certain anesthetics (volatile agents, succinylcholine): rising end-tidal CO₂, rigidity, tachycardia, and later high fever; treat with dantrolene.

Hemorrhage, shock, SSI, atelectasis/pneumonia, DVT/PE, urinary retention, ileus, dehiscence/evisceration, and nausea/vomiting.

Warm IV fluids/irrigation, forced-air warming blankets, and a warm OR; normothermia lowers SSI and bleeding risk.

Adhesive strips that approximate skin edges, used alone for small wounds or to reinforce a sutured/stapled incision.

The dressing, drains, and specimen are documented; counts must be correct and recorded before the patient leaves the OR.

Continuous end-tidal CO₂ monitoring confirms ventilation and tube placement; a sharp rise is an early sign of malignant hyperthermia.

A noninvasive measure of arterial oxygen saturation; normal is at least 95%; falling values signal hypoxemia.

Inadequate tissue perfusion; types include hypovolemic (blood/fluid loss), cardiogenic, distributive (septic/anaphylactic), and obstructive.

Sequential compression devices, early mobilization, and anticoagulants reduce deep vein thrombosis and pulmonary embolism risk.

Certified Surgical Technologist — the NBSTSA credential for the surgical technologist who prepares the OR and assists during surgery, primarily in the scrub role.

AST (Association of Surgical Technologists) is the professional association; NBSTSA (National Board of Surgical Technology and Surgical Assisting) develops and awards the CST credential.

Graduation from a surgical technology program accredited by CAAHEP or ABHES qualifies a candidate to sit for the CST exam.

Maintain the CST by earning continuing education credits over a multi-year cycle (commonly 60 CE credits over 4 years) or by re-examination.

The surgeon (provider) is responsible for obtaining informed consent; the team verifies it is signed, complete, and matches the planned procedure/site.

Report concerns through the proper line (charge nurse, supervisor, manager); the CST escalates patient-safety or sterility issues appropriately.

Practice within the legally and facility-defined CST role; do not perform tasks outside training/credentialing (e.g., independent prescribing or surgeon-only acts).

Counts, implants (with lot/serial), specimens, medications, and equipment used must be documented accurately and legibly in the operative record.

Protect patient health information; discuss cases only with the care team and only as needed for care.

Wear clean surgical attire, cover all hair, and don a mask in restricted areas; traffic and door openings increase contamination risk.

A surgeon-specific record of preferred instruments, supplies, sutures, gloves, and setup for a given procedure — used to pull the case.

Verify size/type, keep implants sterile, and record the manufacturer, lot/serial number, and expiration in the operative record for traceability.

Sets workplace safety standards (bloodborne pathogens, hazard communication, sharps safety, surgical smoke) to protect staff.

Use latex-free gloves and supplies, schedule the case first (lowest airborne latex), and post signage to prevent anaphylaxis.

Maintain par levels, rotate stock by expiration (FIFO), and restock case carts so supplies are available and unexpired.

The hinge joint of a ringed instrument where the two halves cross; inspect and clean it because debris collects there.

Between cases, surfaces and equipment are cleaned/disinfected; terminal cleaning (end of day) is a thorough decontamination of the entire room.

The first step of instrument processing: cleaning/disinfection to remove blood, debris, and microbes so an item is safe to handle before sterilization.

Items entering sterile tissue or the vascular system (surgical instruments, implants) — must be STERILIZED.

Items contacting mucous membranes or non-intact skin (endoscopes, laryngoscope blades) — require at least high-level disinfection.

Items contacting only intact skin (BP cuffs, OR table) — require low- or intermediate-level disinfection.

Sterilization destroys ALL microbial life including spores; disinfection destroys most pathogens but not necessarily all spores.

Moist heat under pressure (e.g., 250°F/121°C gravity or 270°F/132°C prevacuum) — the most common, economical method for heat/moisture-stable items.

Organic debris (blood/protein) shields microbes and prevents the sterilant from contacting all surfaces, so cleaning must precede sterilization.

A low-temperature gas method for heat- and moisture-sensitive items; effective but toxic, flammable, and requires lengthy aeration.

A low-temperature method (e.g., Sterrad) for delicate/heat-sensitive items; fast aeration, no toxic residue, but lumen/cellulose limits.

A liquid chemical sterilant used for immersible heat-sensitive items like endoscopes; just-in-time, not for long storage.

Formerly 'flash' sterilization for an item needed immediately; minimize its use — items are not packaged for storage and must be used at once.

A vial of resistant bacterial spores (Geobacillus stearothermophilus for steam) processed and incubated to confirm the sterilizer actually killed spores.

A tape/strip/integrator that changes color to show an item was EXPOSED to the sterilant — but does NOT prove sterility (only the BI does).

A daily air-removal/steam-penetration test for prevacuum steam sterilizers, run in an empty chamber before the first load.

The sterilizer's gauges/printouts of time, temperature, and pressure that verify the cycle ran within parameters.

A package stays sterile until an event compromises it (tear, wetness, drop) — not a fixed expiration date — given proper storage.

Check the integrity (no tears/holes/moisture), the chemical indicator change, and the package seal before opening onto the field.

Open box locks/ratchets, place items so the sterilant contacts all surfaces, do not overload, and position basins/cups on edge to drain.

Place the package paper-to-paper and plastic-to-plastic, and present so the steam/sterilant can enter — open toward the sterile field for delivery.

Flush and brush lumens; some low-temp methods require lumen length/diameter limits or adapters so the sterilant reaches the inside.

Uses cavitation (sound-wave bubbles) to remove fine debris from box locks, serrations, and crevices after gross cleaning.

A water-soluble, steam-permeable lubricant applied to hinged instruments to maintain action and prevent stiffness/spotting.

A detergent containing enzymes that break down blood, protein, and other organic soil during decontamination.

Move from dirty (decontamination) to clean (prep/pack) to sterile (sterilizer/storage) — never backward — to prevent recontamination.

Wear gloves, a fluid-resistant gown, a mask, and eye/face protection because of splash and bioburden when cleaning soiled instruments.

Sequential or simultaneous double wrapping (or a rigid container) maintains a sterile barrier and allows aseptic opening.

Store in a clean, dry, low-traffic area; off the floor, away from vents/sprinklers, with controlled temperature and humidity.

Prions resist standard sterilization; use special extended protocols, single-use items when possible, or destruction per policy for suspected CJD.

Do not immerse motors unless rated; clean, lubricate, and test drills/saws per manufacturer instructions for use (IFU).

Always follow the device manufacturer's instructions for use for cleaning, lubrication, and the validated sterilization method/parameters.

The reference posture: standing erect, facing forward, arms at sides, palms forward — used to describe all directional terms.

Superior = toward the head (upper); inferior = toward the feet (lower).

Anterior = toward the front of the body; posterior = toward the back.

Medial = toward the midline; lateral = away from the midline (toward the side).

Proximal = closer to the trunk/point of attachment; distal = farther from it (e.g., the wrist is distal to the elbow).

Sagittal = divides left/right; coronal (frontal) = divides front/back; transverse (axial) = divides top/bottom.

RUQ, LUQ, RLQ, LLQ — divided by lines through the umbilicus; locate organs (e.g., appendix in the RLQ).

Skin → subcutaneous (Camper's/Scarpa's fascia) → muscle/fascia (rectus/external oblique) → transversalis fascia → preperitoneal fat → peritoneum.

Serous membranes lining cavities: pericardium (heart), pleura (lungs), peritoneum (abdominal cavity).

Mucosa → submucosa → muscularis (externa) → serosa (or adventitia) — from lumen outward.

Right atrium, right ventricle, left atrium, left ventricle; the right side pumps to the lungs, the left side to the body.

Tricuspid (RA→RV), pulmonary (RV→lungs), mitral/bicuspid (LA→LV), aortic (LV→body) — keep blood flowing one way.

The right and left coronary arteries (LAD, circumflex branches) supply the heart muscle itself.

RV → pulmonary artery → lungs (oxygenated) → pulmonary veins → left atrium (pulmonary circulation).

Esophagus → stomach → duodenum → jejunum → ileum → cecum → colon (ascending, transverse, descending, sigmoid) → rectum → anus.

Liver, gallbladder, and pancreas — produce/store bile and enzymes that aid digestion.

Bile flows: liver → hepatic ducts → common hepatic duct; gallbladder → cystic duct → common bile duct → duodenum (via ampulla of Vater).

The landmark in cholecystectomy bounded by the cystic duct, common hepatic duct, and liver; the cystic artery runs within it.

Kidneys → ureters → bladder → urethra; the kidneys filter blood and form urine (nephron is the functional unit).

Dura mater (outer), arachnoid (middle), pia mater (inner) cover the brain and spinal cord; CSF sits in the subarachnoid space.

Ovaries → fallopian tubes → uterus → cervix → vagina; relevant to hysterectomy, salpingectomy, and oophorectomy.

Testes → epididymis → vas deferens → seminal vesicles/prostate → urethra; relevant to vasectomy, prostatectomy, and orchiectomy.

Diaphysis (shaft), epiphysis (ends), metaphysis, periosteum (outer membrane), and medullary cavity (marrow).

Forearm: radius (lateral, thumb side) and ulna (medial). Lower leg: tibia (shinbone) and fibula (lateral).

Cornea, anterior chamber, iris/pupil, lens, vitreous, retina; relevant to cataract and retinal surgery.

Outer (auricle, canal), middle (ossicles: malleus, incus, stapes; tympanic membrane), inner (cochlea, vestibule); relevant to myringotomy.

Nose → pharynx → larynx → trachea → bronchi → bronchioles → alveoli (site of gas exchange).

Epithelial (covers/lines), connective (supports, e.g., bone/blood), muscle (contracts), and nervous (transmits impulses).

The body's maintenance of a stable internal environment (temperature, pH, fluid/electrolyte balance) despite external changes.

Thyroid and parathyroids (neck), adrenal glands (atop kidneys), pituitary (brain), and pancreas (islets) — sites of common procedures.

HR ~60–100/min, RR ~12–20/min, BP ~120/80 mmHg, temp ~98.6°F/37°C, SpO₂ at least 95% — baseline patient monitoring values.

A microscopic living organism — bacteria, viruses, fungi, protozoa, and prions are the groups relevant to surgical infection control.

Cocci (spheres), bacilli (rods), and spirilla/spirochetes (spirals); arrangements include strepto- (chains) and staphylo- (clusters).

Gram-positive bacteria stain purple (thick peptidoglycan wall); Gram-negative stain pink/red (thin wall + outer membrane). Guides antibiotics.

A Gram-positive cluster-forming cocci; a leading SSI cause. MRSA is methicillin-resistant and requires contact precautions.

Dormant, highly resistant forms (e.g., Clostridium, Bacillus) that survive heat/chemicals; sterilization must kill spores.

Spore-forming anaerobes: C. difficile causes colitis (needs soap-and-water hand washing); C. tetani causes tetanus.

Aerobes require oxygen; anaerobes grow without it (and many are killed by oxygen) — affects culture method and antibiotic choice.

A Gram-negative aerobic rod, common in moist environments; an opportunistic SSI and burn-wound pathogen.

A pathogen causes disease; normal flora are resident microbes that are usually harmless but can cause infection if displaced (e.g., gut flora in the peritoneum).

Agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host; breaking any link prevents infection.

Contact (direct/indirect), droplet, airborne, vehicle (food/water/blood), and vector — guide isolation precautions.

Treat all blood and body fluids as potentially infectious: hand hygiene, gloves, gowns, masks/eye protection, and safe sharps handling for every patient.

Viruses transmitted via blood/body fluids; the main occupational risk after a needlestick — follow exposure protocol and report immediately.

Staphylococcus aureus (incl. MRSA), coagulase-negative staph, Enterococcus, E. coli, and Pseudomonas.

A virus is an acellular particle that must replicate inside a host cell (not killed by antibiotics); a bacterium is a single-celled organism.

Yeasts (Candida) and molds (Aspergillus) cause opportunistic infections, especially in immunocompromised patients.

An infection acquired in a healthcare setting (e.g., SSI, CAUTI, CLABSI, VAP) not present on admission.

The single most effective measure to prevent the spread of infection; use alcohol-based rub or soap-and-water (soap for spores like C. diff).

Resident flora live deep in skin layers (hard to remove); transient flora sit on the surface and are removed by handwashing/scrub.

Endogenous = from the patient's own flora; exogenous = from an outside source (staff, instruments, environment).

The antidote for malignant hyperthermia; the CST/team helps reconstitute many vials rapidly while the agent is stopped and the patient is cooled.

Generic = the official nonproprietary drug name (lowercase); trade/brand = the manufacturer's name (capitalized), e.g., epinephrine vs Adrenalin.

Topical, oral (PO), IV, IM, subcutaneous, intrathecal, and on-field instillation/irrigation; the CST handles many drugs ON the sterile field.

Label EVERY medication, container, and solution on the field immediately (even one), and verify the drug, strength, and expiration aloud with the circulator.

Lidocaine, bupivacaine (Marcaine), and procaine — block nerve conduction for local/regional anesthesia; lidocaine onset is fast, bupivacaine lasts longer.

Epinephrine causes vasoconstriction, which prolongs the anesthetic's action and reduces bleeding — but avoid in end-arteries (fingers, toes, nose, penis).

General = unconscious, whole-body; regional = a region numbed (spinal, epidural, block) with the patient awake; local = a small area numbed.

Inhalation agents (sevoflurane, desflurane, nitrous oxide) and IV agents (propofol, ketamine, etomidate); muscle relaxants paralyze for intubation.

Depolarizing (succinylcholine — fast, short) and non-depolarizing (rocuronium, vecuronium) relax muscles; succinylcholine can trigger MH.

Normal saline (0.9% NaCl) and sterile water; warmed for normothermia. Choice depends on the tissue (e.g., not water near open vessels due to hemolysis).

An anticoagulant used on the field (e.g., vascular cases) to prevent clotting; its reversal agent is protamine sulfate.

The reversal agent for heparin; given to neutralize anticoagulation (e.g., after vascular/cardiac procedures).

A topical hemostatic agent applied to a bleeding surface to promote clotting; never inject it intravascularly.

Radiopaque dyes (e.g., for cholangiography) injected to visualize ducts/vessels on fluoroscopy; ask about iodine/shellfish allergy.

Methylene blue, gentian violet, and indigo carmine — mark tissue/margins or identify structures (e.g., methylene blue for leaks).

Prophylactic antibiotics (often a cephalosporin like cefazolin) are given before incision; antibiotic irrigation may be used on the field per surgeon.

Use the metric system: 1 g = 1,000 mg, 1 mg = 1,000 mcg, 1 L = 1,000 mL; percent solution = g of drug per 100 mL.

1% = 1 g per 100 mL = 10 mg/mL; so a 10 mL vial of 1% lidocaine contains 100 mg.

Right patient, right drug, right dose, right route, right time, and right documentation — confirmed when handling drugs on the field.

Drugs with abuse potential (e.g., opioids) are scheduled (C-II to C-V), tracked, counted, and witnessed for waste per DEA/facility policy.

Confirm allergies (latex, iodine, medications) before prep/anesthesia; communicate them to the team and document.

A severe allergic reaction (latex, drugs, contrast): hypotension, bronchospasm, hives, and edema; treated with epinephrine — keep it available.