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
INTRODUCTION TO THE OPERATING ROOM
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.
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
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
f. Aseptic Technique. The method by which
contamination with microorganisms is prevented. Also called "sterile
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
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
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
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
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
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
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
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
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.
Procedures for an Operation