Examination and Treatment Areas

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9

• Examination and Treatment Areas

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Learning Outcomes (cont.)

• 9.1 Describe the layout and features of a typical
  examination room.
• 9.2 Differentiate between sanitization and
  disinfection.
• 9.3 List steps to prevent the spread of infection
  in the exam and treatment rooms.

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Learning Outcomes (cont.)

• 9.4 Describe the importance of temperature,
  lighting, and ventilation in the exam room.
• 9.5 Identify instruments and supplies used in a
  general physical exam and tell how to
  arrange and prepare them.

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Introduction

• Care and maintenance of exam room
• Equipment
• Supplies
• Infection control practices

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The Exam Room

• Number and size of rooms
• Two per physician
• Accommodate the physician, patient, and one
  assistant
• Supplies and equipment must be in reach

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Furnishings

• Arrangement
• Efficiency
• Patient comfort
• Physician convenience

• Examining table
• Step
• Drawers
• Adjustable positioning

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Furnishings

• Items commonly found in exam rooms

• One or more chairs
• A rolling stool
• Weight scale
• Biohazard container

• Wastebasket with lid
• Puncture-proof containers
• Wall brackets
• High-intensity lamp

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Special Features

• The 1990 Americans with Disabilities Act (ADA)
• Requires reasonable accommodations
• Accessibility
• Guidelines

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Apply Your Knowledge
When arranging an examination room, what three
things should you consider?
ANSWER You need to consider efficiency, patient
comfort, and physician convenience when arranging
an examination room.
Right!
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Sanitization and Disinfection

• Sanitization
• For cleaning items that touch only healthy,
  intact skin
• First step in disinfection and sterilization for
  other equipment

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Sanitization (cont.)

• Collect items for sanitization
• PPE
• Separate sharps from other equipment
• Scrub items
• Small brush
• Neutral pH detergent
• Dry

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Sanitization (cont.)

• Rubber and plastic items
• Ultrasonic cleaning
• For delicate instruments and those with moving
  parts
• Sound waves generated through a cleaning solution
  to loosen contaminants

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Disinfection

• Adequate for some instruments
• For others, it is the second step prior to
  sterilization
• Sterilization is necessary for visible
  contamination with blood

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Disinfection (cont.)

• Using disinfectants
• Cleaning products for inanimate materials
• Reduce or eliminate infectious organisms
• Manufacturers guidelines
• Effectiveness

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Disinfection (cont.)

• Choose the correct disinfectant
• Handling disinfected supplies
• Prevent contamination with other surfaces
• Use sterile transfer forceps
• Wear gloves
• Store in clean, moisture-free environment

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Apply Your Knowledge
What is sanitation and for what items is
sanitation adequate for cleaning?
ANSWER Sanitation is scrubbing with a brush and
detergent to remove blood, mucus, and other
contaminants or media where pathogens can grow.
It is adequate for cleaning items that touch only
healthy, intact skin.
Nice Job!
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Preparation of the Exam and Treatment Areas

• Clean and well organized
• Safeguards
• Making hand hygiene a priority
• Keeping the examining table clean and
• Disinfecting all work surfaces.

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Infection Control

• Hand hygiene
• Handwashing
• Alcohol-based hand cleaners

• Examining Table
• Paper cover
• Linens

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Infection Control (cont.)

• Disinfect surfaces
• Visibly contaminated with tissue, blood or other
  body fluids
• At end of shift
• Per office schedule

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Infection Control (cont.)

• Storage
• Store biohazardous specimens properly
• Work practice controls
• Store testing kits properly

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Putting the Room in Order

• Straighten and put items away
• Contributes to physical safety
• Housekeeping

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Apply Your Knowledge
Other than at the end of your shift, when should
you disinfect the surfaces in the examination
rooms?
ANSWER Whenever there is visible contamination
with blood, body fluid, or body tissue.
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Room Temperature, Lighting, and Ventilation

• Maintain examination room temperature at about
  72F
• Eliminate drafts

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Lighting

• Accurate diagnoses
• Perform medical procedures
• Read orders and instructions
• Prevent accidents

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Ventilation

• Examination area should smell clean and fresh
• Eliminate source of odors
• If opening windows, monitor room temperature
• Room deodorizer or spray

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Apply Your Knowledge
Why is it important to have good lighting in the
examination room?
ANSWER Good lighting is needed for making
accurate diagnoses, performing medical
procedures, reading orders and instructions, and
preventing accidents.
Excellent!
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Medical Instruments and Supplies

• Maintain instruments and supplies
• Order and stock all needed supplies
• Sanitize, disinfect, and/or sterilize instruments
  as needed
• Instruments and supplies should be placed within
  easy reach for the physician

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Instruments Used in a General Physical Exam
Instrument Purpose
Anoscope Used to open the anus for examination
Exam light Provides additional lighting
Laryngeal mirror Reflects inside of mouth and throat
Nasal speculum Used to enlarge the opening of the nose
Ophthalmoscope Used to examine the inner eye surfaces
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Instruments for a General Physical Exam (cont.)
Instrument Purpose
Otoscope Used to examine the inner ear
Penlight Small flashlight used to view a small area
Reflex hammer Used to check patients reflexes
Sphygmomanometer Used to measure blood pressure
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Instruments for a General Physical Exam (cont.)
Instrument Purpose
Stethoscope Used to listen to body sounds
Tape measure Used to measure size or development of an area
Thermometer Used to measure body temperature
Tuning fork Used to test hearing
Vaginal speculum Used to enlarge the vagina for specimens from cervix and vagina
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Instruments for a General Physical Exam (cont.)

• Inspecting and maintaining instruments
• Arranging instruments
• Mounted on wall
• Out on countertop
• Set on a clean towel or tray

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Instruments for a General Physical Exam (cont.)

• Preparing instruments
• Cleaning instruments
• Dispose of supplies in the appropriate containers
• Use approved procedures for sanitizing,
  disinfecting, and sterilizing

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Supplies for a General Physical Exam
Needles and Syringes
Cervical scraper
Curettes
Sterile and clean gloves
Cotton balls
Cotton-tipped applicators
Gauze, dressings, and bandages
Glass slides
Paper tissues
Specimen containers
Occult blood test slides
Tongue depressors
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Supplies for a General Physical Exam (cont.)

• Consumable supplies
• Fixative
• Isopropyl alcohol
• Lubricant
• Be sure patients do not have access to
• Prescription blanks
• Drugs
• Needles

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Supplies for a General Physical Exam (cont.)

• Store supplies
• Label drawers
• Put items back in correct place
• Routinely straighten and clean

• Restocking supplies

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Apply Your Knowledge
A medical assistant is preparing the treatment
room for a local ENT specialist. Which of the
following instruments might be used in this
office to assess patient ear, nose, and throat
functioning?
ANSWER
penlight
nasal speculum
laryngeal mirror
tuning fork
ophthalmoscope
otoscope
Good Choices!
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In Summary

• 9.1 A typical examination room is about 8 by 12
  feet, large enough to accommodate the
  physician, the patient, and one assistant.
  Instruments and equipment in the room
  should be easily accessible.
• 9.2 Sanitization is the scrubbing of instruments
  and equipment with special brushes and
  detergent to remove blood, mucus, and
  other contaminants or media where
  pathogens can grow. Disinfection uses
  special cleaning products applied to instruments
  and equipment to reduce or eliminate
  infectious organisms.

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In Summary (cont.)

• 9.3 Steps involved in preventing the spread of
  infection in the examination room include
  covering the examination table with a
  paper cover and changing the cover between
  each patient. It is also important to disinfect
  all surfaces that come in contact with
  blood or body fluids after each patient,
  and at the beginning and end of the day.
• 9.4 It is important that patients feel
  comfortable in the examination room. A
  comfortably warm, well lit, and properly
  ventilated room will help the patient feel
  comfortable during his examination.

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In Summary (cont.)

• 9.5 A variety of instruments and supplies are
  used in a general physical examination. To
  ensure the examination room always has the
  necessary instruments and supplies, the
  medical assistant should order and stock
  all supplies needed for examinations and
  treatment procedures keep the instruments
  sanitized, disinfected, or sterilized and in
  working order and place all instruments
  and supplies where the physician can
  easily reach them.

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End of Chapter 9
As a general thing, an individual who is neat in
his person is neat in his morals Henry Wheeler
Shaw