Operational Medicine Medical Education and Training

Routine Procedures for an Operation

CORRESPONDENCE COURSE

U.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL

SUBCOURSE MD0935 EDITION 100

ROUTINE PROCEDURES FOR AN OPERATION

When you are assigned to scrub or to circulate for an operation, you are expected to perform a series of tasks in the manner established by local policy and in the order prescribed. These tasks begin with the preparation for the surgical procedure and continue until the case is finished and the cleanup of the room is complete.

The tasks are done so as to protect the sterile setup, to prevent fires and explosions, and to expedite the surgical procedure. The underlying purpose of all the tasks is to afford maximum protection to the patient while rendering the best care possible.

Study of the text will enable you to familiarize yourself with the tasks you should perform when assigned to scrub or to circulate for surgery. You will enhance your skill and proficiency in the performance of these tasks by doing them under competent supervision.

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Length: 98 Pages

Estimated Hours to Complete: 10

Format: PDF file

Size: 0.7 MB

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Anyone may take this course. However, to receive credit hours, you must be officially enrolled and complete an examination furnished by the Nonresident Instruction Branch at Fort Sam Houston, Texas. Enrollment is normally limited to Department of Defense personnel. Others may apply for enrollment, but acceptance is not guaranteed.

 

Passing instruments during surgery

Routine Procedures for an Operation

Distance Learning Course
98 Pages
Est. 10 Hours
0.7 MB pdf file

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Drying Hands in the Operating Room

TABLE OF CONTENTS

 

INTRODUCTION

1 INTRODUCTION TO THE OPERATING ROOM

2 CLEANING THE OPERATING ROOM SUITE

3 PREPARATION OF THE OPERATING ROOM FOR SURGERY

Section I. Duties of the Operating Room

Specialist as a Circulator

Section II. Duties of the Operating Room

Specialist as a Scrub

4 PROCEDURES DURING AND FOLLOWING SURGERY

Section I. Procedures During Surgery

Section II. Procedures Following Surgery

Section III. Procedures For A Laparotomy

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LESSON 1

INTRODUCTION TO THE OPERATING ROOM

1-1. GENERAL

a. In carrying out the many tasks necessary for a day's surgery, operating room (OR) specialists must coordinate their work to provide a safe and efficient environment for the patient. Lack of coordination (or teamwork) results in errors, misunderstandings between personnel, and waste of time. In view of the nature of the care given the patient in the operating room, any of these results may have dire consequences for the patient.

b. Professional personnel are responsible for developing a systematic method (work plan) for operative procedures. Operating room specialists, under the supervision of professional nurses and the noncommissioned officer in charge (NCOIC), are responsible for learning and acquiring optimum skill in performing their tasks in accordance with the methods that have been developed. The enlisted operating room specialist should be aware of his area of responsibility and should realize that each step or detail in a procedure is important. Methods for performing procedures vary among operating room suites, but the rules for observing aseptic technique and the duties of the circulator and the scrub discussed in this text are basic to every operative procedure. The operating room specialist may be assigned to perform duties as the circulator or the scrub during a surgical procedure.

1-2. DEFINITIONS

An important part of your duties as an operating room specialist is your ability to communicate with the professional staff in the operating room, other operating room specialists, and the support staff for the operating room. Understanding the use and meaning of terminology used within the operating room is an important part of this subcourse. Some of the words listed in the following paragraphs have been defined in previous subcourses, but are included to refresh your operating room vocabulary.

a. Anesthesia. General or local insensibility to pain and other sensation induced by certain drugs.

b. Anesthetist. One who administers anesthetics. This person may be a nurse anesthetist or a physician anesthesiologist.

c. Antisepsis. The prevention of sepsis by the exclusion, destruction, or inhibition of growth or multiplication of microorganisms from body tissues and fluids.

d. Antiseptics. Chemical agents that fight sepsis by inhibiting growth of microorganisms without necessarily killing them; used only on living tissue.

e. Asepsis. The absence of microorganisms that cause diseases.

f. Aseptic Technique. The method by which contamination with microorganisms is prevented. Also called "sterile technique."

g. Autoclave. A sterilizing apparatus that uses saturated steam under pressure.

h. Bacteria. One category of microorganisms. Microorganisms are of great concern to hospital personnel because they are difficult to destroy and produce many different diseases.

i. Bagged. Method of enclosing supplies and equipment. This may be done by plastic or paper to prevent the spread of infection or to maintain sterility.

j. Circulator. The technician on the operating room team who functions outside of the sterile field during surgery.

k. Contaminated. Soiled with microorganisms.

l. Cross Contamination. Transmission of microorganisms from patient to patient and from contaminated objects to patients and vice versa.

m. Detergent. A cleansing agent that facilitates removal of grease or soil. A suitable detergent must be selected; it must clean but not injure the surface of the article.

n. Disease. A condition in which there is incorrect or poor functioning of any part, organ, or system of the body.

o. Disinfectant. An agent that kills all growing forms of microorganisms, thus completely eliminating them from objects; used only on inanimate objects.

p. Disinfection. The chemical or physical process of destroying all pathogenic microorganisms except spore-bearing ones. Disinfectants are used on objects--not on tissue.

q. Disposables. Commercially prepackaged, usually pre-sterilized items, designed for one-time use.

r. Draping. The procedure of covering the patient and surrounding areas with a sterile barrier to create and maintain an adequate sterile field during an operation. Drapes include towels and sheets and may be disposable.

s. Germ. A common term for a microscopic or submicroscopic organism capable of producing disease.

t. Hopper. A large utility sink equipped with a flushing device. Used to dispose of contaminated waste.

u. Infection. Invasion of the body by pathogenic microorganisms and the reaction of tissues to their presence.

v. Microorganisms. Living organisms that cannot be seen with the naked eye, including bacteria, fungi, viruses, yeasts, and molds; also called "microbial life."

w. Procedure. A particular way of doing something; a series of steps followed in a definite order; a traditional way of doing things.

x. Process. A series of procedures designed to prepare supplies and equipment for use in giving patient care.

y. Principle. The basis upon which the correct way of doing something is determined. A reference to the principles or procedures that leads to the right way of doing something.

z. Sanitation. A process whereby microorganisms present on an object are reduced in number to a level considered safe for human use.

aa. Sanitizer. An apparatus employing a sanitizing agent such as hot water, steam, or chemicals.

bb. Scrub. The technician on the operating room team who scrubs, dons sterile gown and gloves, and functions within the sterile area.

cc. Sepsis. Invasion of the body by pyrogenic microorganisms.

dd. Sponge. A sterile surgical dressing of absorbent material for wiping or absorbing blood or other fluids during an operation.

ee. Sponge, Radiopaque. This type of sponge has multiple layers of absorbent gauze with a radiopaque thread sewn in. It is used to control bleeding during all types of surgery.

ff. Sterile. Free of microorganisms (bacterial, spores, and germs invisible to the naked eye).

gg. Sterile Field. The area of the operating room that immediately surrounds and is especially prepared for the patient. To establish the sterile field, all items needed for the operation are sterilized and only sterile team members function within the sterile area.

hh. Sterilizer. Apparatus using saturated steam under pressure, ethylene oxide, or dry heat as the sterilizing agent. These include gravity and mechanical types.

ii. Sterilization. The process by which all pathogenic and nonpathogenic microorganisms, including spores, are killed.

jj. Surgical Procedure. A set of steps by which a desired result is accomplished by surgery, which is the treatment of diseases and injuries by manual or operative methods.

kk. Surgical Team or Operating Room Team. Surgeon, one or more assistant surgeons, a scrub nurse or technician, an anesthetist, and a circulating nurse or technician makes up the surgical team.

ll. Surgical Needles. Surgical needles are straight or curved needles used to safely carry suture material through tissue with the least amount of effort. Needles must also be sterile.

mm. Surgically Clean. Mechanically or physically cleaned, but unsterile. Items are rendered surgically clean by the use of chemical, physical, or mechanical means that reduce the number of microorganisms on them.

nn. Suture (verb). Suturing is the act of sewing by bringing tissues together and holding them until healing has taken place.

oo. Suture (noun). A suture is any strand of material used to sew tissue together. Suturing material must be sterile. Ligature is a strand of suture material used to "tie off" or seal blood vessels to prevent bleeding.

pp. Suture Card or Surgeon's Preference Card. This card lists the surgeon's usual suture and needle routine by tissue layer and preference for instrument equipment and position of patient.

qq. Terminal Sterilization and Disinfection. The procedures carried out for the destruction of pathogens on instruments and supplies before they are handled for complete cleaning and checked for proper functioning. Terminal sterilization is often done by the using unit to protect personnel handling the items.

From Routine Procedures for an Operation

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