I hope that the content of my ppt will be very good for all of you in which ppt subject is "sterile & non- sterile trolley setup" in which we have describe how to use sterile & non-sterile trolley up in surgical procedures

1. DR. GOURAV KUMAR
Assistant professor
Department of Radiation and Imaging Technology
NIMS University, Jaipur Rajasthan

2.  A sterile trolley involves ensuring that all the necessary equipment and
supplies are organized and maintained in a sterile manner for use in
medical procedures or other sterile environments. Here's a general
guideline on how to set up a sterile trolley:
 Clean the Work Area: Start by cleaning the surface where the sterile
trolley will be placed. Use a disinfectant to wipe down the surface
thoroughly.

3.  Gather Necessary Equipment and Supplies: Collect all the required
sterile equipment and supplies needed for the procedure. This might
include items such as:
 Sterile gloves
 Sterile gauze
 Sterile drapes
 Sterile dressings
 Sterile syringes and needles
 Antiseptic solutions (e.g., alcohol swabs, iodine solution)
 Sterile instruments (forceps, scissors, etc.)
 Sterile trays or containers for organizing smaller items

4.  Prepare the Trolley: Arrange the trolley trays or compartments in an
organized manner, ensuring that each item has its designated place.
Larger items might be placed on the bottom shelf, while smaller items
or instruments can be organized in trays or containers on higher
shelves.
 Open Sterile Packages Carefully: Before placing items onto the
trolley, open sterile packages using proper aseptic technique. Avoid
touching the sterile contents with non-sterile hands or surfaces.

5.  Arrange Items on the Trolley: Place the opened sterile items onto the
designated areas of the trolley. Arrange them in a logical order based
on the procedure they will be used for, keeping frequently used items
easily accessible.
 Maintain Sterility: Throughout the setup process, be mindful of
maintaining sterility. Avoid contaminating sterile items by ensuring
that non-sterile surfaces, hands, or items don't come into contact with
them.

6.  Cover or Wrap Unused Items: If there are items that won't be
immediately used but need to remain sterile, cover them with
sterile drapes or place them in appropriate sterile containers to
maintain their sterility until they are needed.
 Labeling and Documentation: If required, label the items or
containers with relevant information. Ensure that any
documentation or labeling necessary for the procedure is readily
available.
 Regular Inspections and Replenishment: Periodically
inspect the sterile trolley to ensure the integrity of the items and
their sterility. Replace any expired items or those that are no
longer sterile.

7. Sterile Gloves –
 Sterile gloves are an essential component in maintaining aseptic or
sterile conditions in various medical procedures, surgeries, and any
situation where there is a need to prevent the transmission of infection
between the healthcare provider and the patient.
 Surgical Procedures: Sterile gloves are crucial during surgical
procedures to prevent contamination of the surgical site by providing a
barrier between the healthcare provider's hands and the patient's body.
Surgeons, nurses, and other operating room personnel wear sterile
gloves to maintain aseptic conditions during surgery.

9.  Invasive Medical Procedures: Healthcare providers use sterile
gloves for various invasive procedures, such as inserting
catheters, performing wound care, or conducting examinations
that involve contact with sterile body sites or fluids.
 Patient Care in Isolation or Sterile Environments: In settings
where patients require isolation or in sterile environments like
an ICU or burn units, healthcare workers use sterile gloves when
providing direct patient care to prevent the transmission of
pathogens.

10.  Handling Contaminated Materials: Sterile gloves can also be used
when handling materials or equipment that are potentially
contaminated, protecting the wearer from exposure to infectious
agents.
 Proper Technique: It's crucial to follow proper hand hygiene and glove
donning techniques before wearing sterile gloves. This includes
thorough hand washing or using hand sanitizer before putting on
gloves to minimize the risk of contaminating the gloves during
application.

11.  Size and Fit: Ensure the gloves fit properly for comfort and dexterity.
Gloves that are too tight can cause hand fatigue and discomfort, while
loose gloves may compromise dexterity and tactile sensitivity.
 Avoid Touching Non-Sterile Surfaces: Once gloves are on, it's essential
to avoid touching non-sterile surfaces to prevent contamination. Care
should be taken not to touch the face, hair, or other non-sterile items
while wearing gloves.
 Change Gloves When Necessary: Change gloves promptly if they
become torn, punctured, or contaminated during a procedure. It's
crucial to maintain the integrity of the sterile barrier.

12.  Dispose of Gloves Properly: After use, discard gloves in appropriate
waste containers following healthcare facility guidelines to prevent the
spread of contamination.
 Invasive Medical Procedures: Healthcare providers use sterile gloves for
various invasive procedures, such as inserting catheters, performing
wound care, or conducting examinations that involve contact with
sterile body sites or fluids.
 Patient Care in Isolation or Sterile Environments: In settings where
patients require isolation or in sterile environments like an ICU or burn
units, healthcare workers use sterile gloves when providing direct
patient care to prevent the transmission of pathogens.

13.  Handling Contaminated Materials: Sterile gloves can also be used
when handling materials or equipment that are potentially
contaminated, protecting the wearer from exposure to infectious
agents.

14.  Sterile gauze is a crucial medical supply used in various
healthcare settings for wound care, surgical procedures, and
other medical applications. Here are some common uses of
sterile gauze:
 Wound Dressing: Sterile gauze is often used as a primary or
secondary dressing for wounds. It helps absorb blood and
exudate, protects the wound from contamination, and promotes
a conducive healing environment. It's applied directly over the
wound after cleaning and may be secured in place with medical
tape or a bandage.

16.  Wound Packing: In deeper wounds or those with irregular
shapes, healthcare professionals may pack the wound with
sterile gauze. This helps to absorb excess fluid, maintain the
wound's shape, and facilitate healing from the inside out.
 Surgical Use: During surgical procedures, sterile gauze is used
by surgeons and assistants to control bleeding, wipe surfaces, or
absorb fluids. It's also used to maintain a sterile field by covering
instruments or placing over incision sites.
 First Aid: In emergency situations or minor injuries, sterile
gauze can be used to apply pressure to stop bleeding or as a
protective covering for cuts, scrapes, or burns.

17.  Absorption and Padding: It's used as padding around
joints or bony prominences to prevent pressure sores, and
as a layer between the skin and a cast to absorb moisture.
 Prepping and Cleaning: Sterile gauze is used to clean and
prepare skin areas before procedures or injections. It's also
used in combination with antiseptic solutions to cleanse
wounds or surgical sites.
 Drainage Management: After surgical procedures where
drains are placed to remove excess fluid, sterile gauze may
be used to cover and protect the drain site.

18.  Sterile drapes play a crucial role in maintaining a sterile field during
surgical procedures and other medical interventions. They are used to
create a barrier between the sterile and non-sterile areas, preventing
contamination and reducing the risk of infections. Here are some
primary uses of sterile drapes:
 Creating Sterile Fields: Sterile drapes are used to cover the patient
and surrounding areas to establish a sterile field. They're laid out
over the patient's body or a specific area where the medical
procedure will take place. This prevents contact between non-sterile
surfaces (such as the patient's skin or non-sterile equipment) and the
surgical site.

20.  Barrier Protection: They act as a physical barrier to block microorganisms,
bodily fluids, and contaminants from reaching the surgical site or the
patient's body. This helps reduce the risk of surgical site infections (SSIs)
and cross-contamination.
 Maintaining Sterility: Sterile drapes are designed to be impervious to liquids
and microorganisms. They maintain their sterile integrity throughout the
procedure, ensuring that the surgical team operates in a controlled and clean
environment.
 Facilitating Access: They are designed with openings or fenestrations that
allow surgeons and medical personnel access to the specific area undergoing
the procedure while keeping the surrounding environment sterile.

21.  Absorbing Exudate: Sterile drapes may have absorbent qualities to manage
fluids or exudate that may be produced during surgery, helping to keep the
area dry and clean.
 Comfort and Safety: They provide a comfortable and safe environment for
both the patient and the medical team by reducing the risk of contamination
and infection transmission.
 Ease of Disposal: Once the procedure is completed, the used sterile drapes
are disposed of properly as medical waste, maintaining infection control
protocols

22.  Sterile dressings are an essential component of wound care used in
various medical settings. These dressings are designed to provide a
clean and sterile environment for wounds, promoting healing and
preventing infection. Here are several key uses of sterile dressings:
 Wound Protection: Sterile dressings act as a protective barrier over
wounds, shielding them from external contaminants such as dirt,
bacteria, and other potentially harmful agents. This barrier helps
reduce the risk of infection and supports the body's natural healing
process.

24.  Absorption of Exudate: Many sterile dressings are designed to absorb
excess wound exudate (fluid that oozes from wounds). They help
maintain a moist environment conducive to healing while preventing
excessive moisture buildup that can impede healing or cause skin
maceration.
 Promotion of Healing: Sterile dressings facilitate a moist wound
environment, which is often beneficial for wound healing. Some
dressings contain substances like hydrogels or alginate that aid in tissue
regeneration and promote healing.

25.  Reducing Pain and Discomfort: Dressings can provide a cushioning
effect, reducing pain and discomfort associated with the wound. They
also protect nerve endings, thereby minimizing pain from friction or
contact.
 Minimizing Scarring: By keeping the wound moist and protected,
certain dressings can help minimize scarring and support the growth of
healthy tissue.
 Control of Bleeding: In cases of minor bleeding or after minor
procedures, sterile dressings can be applied with pressure to help
control bleeding until further medical attention is available.

26.  Post-Surgical Care: Sterile dressings are often used after surgical
procedures to cover incision sites. They help keep the area clean,
minimize the risk of infection, and provide a barrier against external
contaminants.
 Management of Burns: In the case of burns, sterile dressings can
protect the burned area from infection while aiding in healing. Some
dressings are specifically designed for burn care, providing a cooling
effect and protecting against contamination.

27.  Sterile syringes and needles are fundamental medical tools used in
various healthcare settings for a wide range of purposes. Their primary
use involves the safe and sterile administration of medications, fluids,
or substances into the body. Here are some key uses of sterile syringes
and needles:
 Medication Administration: Healthcare professionals use sterile
syringes and needles to accurately measure and deliver medications to
patients via various routes, including intravenous (IV), intramuscular
(IM), subcutaneous (SC), and intradermal (ID) injections.

29.  Vaccinations and Immunizations: Sterile syringes and needles are
crucial for administering vaccines and immunizations to prevent
various infectious diseases. They're used by healthcare providers
during routine vaccinations, mass vaccination campaigns, and in
clinics or hospitals.
 Blood Collection: Sterile syringes equipped with appropriate needles
are used to collect blood samples for diagnostic purposes, such as
laboratory testing, blood donation, or monitoring health conditions.
 Intravenous Therapy: Sterile syringes are utilized for the preparation and
administration of fluids, medications, or blood products through intravenous
lines to maintain hydration, deliver medications, or support patients in
critical care settings.

30.  Diabetes Management: Patients with diabetes use sterile syringes and
needles to self-administer insulin injections for blood sugar control. These
syringes are specifically designed for insulin delivery, allowing precise
measurement and accurate dosing.
 Aspiration and Irrigation: Sterile syringes are used for aspiration,
which involves withdrawing fluids or substances from the body (e.g.,
aspirating fluids from body cavities during medical procedures) or for
irrigating wounds or body parts with sterile solutions.
 Anesthesia Administration: Anesthesiologists use sterile syringes
and needles to administer local anesthesia, nerve blocks, or epidural
injections during surgical procedures or for pain management.

31.  Preventive Measures: The use of sterile syringes and needles is
crucial to prevent the transmission of blood borne infections such as
HIV, hepatitis B, and hepatitis C between patients or healthcare
workers.

32.  Antiseptic solutions, such as alcohol swabs, iodine solution (like
povidone-iodine), chlorhexidine, and others, are essential in
healthcare settings for disinfection, wound preparation, and infection
prevention. These solutions have various applications and play a crucial
role in maintaining cleanliness and preventing the spread of infections.
Here are their primary uses:
 Skin Preparation: Antiseptic solutions are used to disinfect and
prepare the skin before invasive procedures, injections, surgeries, or
when inserting catheters or IV lines. This helps reduce the number of
microorganisms on the skin and minimizes the risk of introducing
bacteria into the body.

34.  Wound Cleansing: Antiseptic solutions are used to clean and disinfect
wounds. They help remove debris, dirt, and bacteria from the wound
site, reducing the risk of infection and promoting faster healing.
 Preoperative Skin Preparation: Before surgery, healthcare
professionals use antiseptic solutions to disinfect the skin surrounding
the surgical site. This process helps decrease the risk of surgical site
infections (SSIs).
 Injection Site Disinfection: Healthcare providers use alcohol swabs
or other antiseptic solutions to clean the skin before giving injections.
This helps minimize the risk of introducing bacteria into the body
through injections.

35.  Catheter and IV Site Preparation: Prior to inserting catheters or
starting IV lines, healthcare providers clean and disinfect the skin
around the insertion site with antiseptic solutions to reduce the risk of
catheter-related infections.
 Mucous Membrane Disinfection: In some medical procedures,
antiseptic solutions may be used to disinfect mucous membranes
before invasive interventions to reduce the risk of infections.
 Preventing Cross-Contamination: Antiseptic solutions are used to
clean surfaces, medical equipment, and instruments to prevent the
spread of infections between patients or healthcare settings.
 Dental Applications: Antiseptic solutions are used in dentistry for
oral rinses, disinfecting oral tissues, and sterilizing dental equipment.

36.  Sterile instruments, including forceps, scissors, scalpels, and other
surgical tools, are essential in healthcare settings, particularly in
surgical procedures and medical interventions. These instruments
undergo sterilization processes to ensure they are free from
microorganisms and safe to use on patients. Here are their primary
uses:
 Surgical Procedures: Sterile instruments are used during surgical
interventions, including incisions, dissections, suturing, and tissue
manipulation. Surgeons and surgical teams rely on these instruments
to perform precise and controlled procedures.

38.  Tissue Handling: Forceps and other sterile instruments are used to
handle delicate tissues or organs during surgeries without causing
damage or contamination.
 Hemostasis: Hemostatic forceps are used to clamp blood vessels,
controlling bleeding during surgeries. They aid in achieving hemostasis
and minimizing blood loss.
 Suturing and Wound Closure: Sterile instruments such as surgical
scissors and needle holders are used for suturing wounds, closing
incisions, and repairing tissues following surgical procedures or
injuries.

39.  Tissue Dissection: Instruments like dissecting scissors, dissectors,
and retractors are used to dissect tissues and provide a clear view of the
surgical site during procedures.
 Biopsy and Sample Collection: Sterile instruments are used to
collect tissue samples or conduct biopsies for diagnostic purposes,
helping to identify and diagnose various medical conditions.
 Dressing Changes: In some cases, sterile instruments are utilized
during wound dressing changes, especially in complex wounds
requiring careful handling and removal of dressings.
 Dental and Ophthalmic Procedures: Sterile instruments are crucial
in dental and ophthalmic surgeries and treatments, including tooth
extractions, root canals, cataract surgeries, and more.

40.  Sterile trays or containers serve a vital role in healthcare settings by
providing a clean and organized way to hold and organize smaller sterile
items and instruments used during medical procedures, surgeries, or
examinations. Here's how they are used and their significance:
 Organization of Instruments and Supplies: Sterile trays or containers
are designed with compartments or sections that help organize and
arrange various smaller sterile items, such as surgical instruments, needles,
sutures, gauze, swabs, and other medical supplies. This organization aids
healthcare professionals in easily accessing the required items during
procedures without compromising sterility.

42.  Maintaining Sterility: These trays or containers are sterile and
specifically designed to uphold the sterility of their contents. They are
typically sealed or covered before use and opened in a controlled
manner in sterile environments to prevent contamination. The sterile
packaging ensures that the instruments and supplies within remain
free from microorganisms.
 Facilitating Efficiency and Workflow: By having a designated space
for each type of instrument or supply, sterile trays or containers help
streamline procedures and improve workflow in medical settings. They
enable healthcare providers to quickly identify and access the
necessary items, enhancing efficiency during procedures.

43.  Reducing Risk of Contamination: Organizing smaller items within
sterile trays or containers minimizes the risk of contamination by
preventing direct contact with non-sterile surfaces. This is particularly
crucial during surgical procedures where maintaining a sterile field is
paramount to prevent infections.
 Customization for Specific Procedures: Sterile trays or containers
can be customized or preassembled with specific instruments and
supplies tailored to particular procedures or medical specialties. This
customization ensures that the required tools for a particular
intervention or examination are readily available and organized for use.

44.  Patient Safety and Infection Prevention: Using sterile trays or
containers helps uphold patient safety by minimizing the risk of
introducing pathogens or contaminants into the patient's body during
medical interventions
 Ease of Handling and Disposal: After use, these trays or containers
are disposed of following proper medical waste disposal protocols,
preventing the reuse of disposable items and ensuring proper infection
control measures.

45.  A non-sterile trolley involves arranging equipment and supplies
needed for procedures or tasks that don't require a sterile
environment, such as in a regular medical examination, wound
care, or general patient care. Here's a list of common equipment
and supplies you might find on a non-sterile trolley setup:

46.  Both latex and non-latex gloves should be available for healthcare
workers to protect themselves and maintain cleanliness.

47.  Disposable Aprons: To maintain personal hygiene and prevent
contamination of clothing.

48.  Sanitizers or soap and water for hand hygiene
before and after patient contact.

49. Wound Care Supplies
 Bandages, wound dressings, adhesive tapes, gauze, cotton
balls, and swabs for basic wound care.

50.  Non-sterile disinfectants, wipes, or solutions for
cleaning surfaces and equipment.

51.  Stethoscope, blood pressure cuff, thermometer, reflex hammer,
otoscope, and ophthalmoscope for routine examinations
Basic Examination Tools

52. Patient Examination Paper/Disposable Sheets
 To cover and maintain cleanliness on examination beds or surfaces.

53.  A secure container for disposal of needles,
syringes, and other sharp medical instruments.

54.  Tweezers, scissors, tongue depressors, and disposable masks for various
procedures.

55.  Non-sterile medications or topical creams frequently used for minor
conditions or first aid.

56.  Pen, paper, or electronic devices for documenting patient information
or notes.

57.  For disposal of non-contaminated waste generated during procedures.

58.  Ruth Ann Ehrlich. 2020 Sterilisation in textbook of Patient
Care in Radiology Seventh Edition, Elsevier New Delhi,
P: 172– 178.