Preoperative Preparation Key Terms
Master these terms to build a strong foundation for the PREOP domain. Terms are grouped by topic area.
Patient Assessment and Verification
Informed consent
The process by which a patient (or authorized representative) voluntarily agrees to a proposed procedure after being informed of its risks, benefits, and alternatives by the surgeon.
Universal Protocol
The Joint Commission standard requiring preprocedure verification, site marking, and a final time-out before starting any procedure to prevent wrong-site, wrong-procedure, or wrong-patient surgery.
Time-out
A mandatory pause immediately before incision during which the entire team actively confirms patient identity, procedure, and surgical site together.
Surgical site marking
Marking the intended incision site, typically by the surgeon, with the patient's participation when possible, before the patient is sedated.
ASA physical status classification
A system (Class I-VI) used by anesthesia providers to describe a patient's preoperative physical condition and associated surgical risk.
NPO status
"Nothing by mouth" - fasting guidelines followed before anesthesia to reduce the risk of aspiration during induction.
Preoperative checklist
A standardized list confirming completed labs, consent, NPO status, allergies, and site marking before the patient enters the OR.
Patient Positioning
Supine position
Patient lying flat on the back; the most common position for abdominal, cardiac, and general procedures.
Trendelenburg position
Supine with the head lower than the feet, used to shift abdominal contents cephalad for pelvic exposure.
Lithotomy position
Patient supine with legs elevated and supported in stirrups, used for gynecologic, urologic, and colorectal procedures.
Prone position
Patient lying face-down, used for spinal and posterior approaches.
Lateral position
Patient positioned on one side, used for thoracic, renal, and hip procedures.
Axillary roll
A padding roll placed below (not in) the dependent axilla in lateral position to prevent brachial plexus compression.
Safety strap
A strap securing the patient to the OR table, placed approximately 2 inches above the knees, never directly over a joint.
Skin Preparation
Surgical skin prep
Application of an antiseptic agent to the surgical site immediately before draping, applied from the incision site outward.
Chlorhexidine gluconate (CHG)
A broad-spectrum antiseptic with strong residual activity, commonly used for surgical skin prep.
Povidone-iodine
An iodine-based antiseptic used for skin prep; contraindicated in patients with iodine allergy.
Hair removal
If needed, performed by clipping (not shaving) immediately before the procedure to reduce microscopic skin trauma and infection risk.
Draping
Sterile field
The draped area immediately around the surgical site considered free of pathogenic microorganisms and reserved for sterile items and personnel.
Fenestrated drape
A drape with a precut opening positioned directly over the prepped incision site.
Strikethrough
Fluid soaking through a drape or gown, compromising the sterile barrier.
Impervious drape
A fluid-resistant drape used in high-fluid procedures to prevent strikethrough contamination.
Room and Equipment Setup
Case cart
A cart containing the sterile supplies, instruments, and equipment needed for a specific scheduled procedure.
Preference card
A surgeon-specific document listing preferred instruments, supplies, sutures, and equipment for each procedure type.
Back table
The main sterile table holding the bulk of instruments and supplies for the case.
Mayo stand
A raised sterile stand positioned over the patient holding the instruments in immediate use.
Surgical scrub
The mechanical and chemical hand and forearm antisepsis process performed before donning a sterile gown and gloves.
Gowning and gloving
The sterile technique used to don a sterile gown and gloves without contaminating the outer sterile surfaces.
Counted-stroke method
A surgical scrub technique using a set number of brush strokes per anatomical area rather than a fixed time.
Anesthesia Readiness
Induction
The phase in which anesthesia is initiated, typically via IV agent, transitioning the patient from awake to unconscious.
Preoxygenation
Administering 100% oxygen before induction to extend the safe apnea window during airway management.
Malignant hyperthermia (MH)
A rare, life-threatening hypermetabolic reaction to certain anesthetic agents requiring immediate dantrolene treatment.
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