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What Is a Sterile Field?

Sterile fields can include people and tools, all of which are aseptic.
Surgical steel instruments are sterilized inside an autoclave.
Everyone must wear medical grade gloves in a sterile field.
A sterile syringe and vial of medication.
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  • Written By: Mary McMahon
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 13 December 2014
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A sterile field is an area kept free of microorganisms to protect the health and safety of a patient during a medical procedure, usually a surgery. This environment is aseptic; all items in the sterile field are sterilized and should not contain microorganisms. Maintaining aseptic conditions is critical for surgical safety, as an infection could be very dangerous for the patient. Medical care providers learn how to create and maintain a safe surgery environment during their training.

Sterile fields can include people and tools, all of which are aseptic. The process of creating such a field starts with the operating room, which should be kept in very clean condition. When a patient prepares for surgery, nurses will scrub the surgical site with antiseptics, and when the patient goes into the operating room, nurses set up a series of sterile drapes to isolate the site of the surgery. This is the start of the sterile field. Instruments will be laid out for the surgeon on another sterile drape, and each should be inside a sterilization pouch with an indicator showing that it has passed through the autoclave.

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Any personnel who work in a sterile field must scrub their hands and arms thoroughly, and wear gowns and gloves as well as cover their hair. While in surgery, they maintain sterility by making sure they do not touch any people or objects that are not sterile. If a surgeon drops a tool on the floor, it is no longer sterile. If she bends down to look at it, she isn't sterile either, because she has passed outside the boundaries of the sterilized area.

A nurse known as a circulator monitors conditions in the sterile field. He is not sterile, and can walk freely around the operating room to look out for health and safety concerns. The general rule of thumb is that if the aseptic status of a person or tool is unclear, it should be considered nonsterile. If a nonsterile person or tool enters the sterile field, the field is contaminated and must be resterilized.

Visitors to operating rooms, like interns and student nurses in their training, may find that they run afoul of the sterile field rules. Operating room visitors can reduce the risk of creating a problem by standing well clear unless specifically invited to move closer. They should not touch the personnel who are "scrubbed in" to work in the sterile area, and should ask for permission before undertaking an activity like picking up a fallen instrument.

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shell4life
Post 3

If ever a person needed to be a germophobe, it would be in the hospital. I've always joked that my mother would have made an excellent surgeon, because she washes her hands dozens of times a day under hot water for half a minute.

A sterile field could really benefit from people like this. I would hate to have someone who was lax about cleanliness and procedure in the operating room working on me.

I realize that many people think that the requirements for a sterile field are over the top, but they have to think about what is at stake. You can't be too careful about the environment in which you are about to cut someone open and expose them to whatever is lurking there.

Perdido
Post 2

@Oceana – The lack of a sterile field might not be the problem. Staph is highly contagious, and people in hospitals generally have weakened immune systems, anyway. They could be getting it just as easily from visitors as from infected instruments.

I have heard that staph can live on a healthy person's skin. All that person would have to do would be hug the ill patient to transfer the staph. Since the patient is already vulnerable to infection, it could set in easily.

So, your local hospital might have a sterile field, after all. Staph is a problem in many big hospitals with good reputations, too.

Oceana
Post 1

I think that staff at my local hospital must be having trouble maintaining a sterile field. It could be that they just don't care or they just don't adhere as closely to the rules as staff at bigger hospitals.

In my circle of friends alone, there have been three people who have developed staph infections while in this hospital. One developed it after having a C-section, and two got it after having kidney stones surgically removed.

I don't know why staph infection is so common at some hospitals, but I suspect it must have something to do with the inability to keep the instruments sterile. It is a shame that the one place you go to get help makes you even sicker sometimes.

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