Assisting the Surgeon Flashcards
What is the aim of aseptic transfer techniques?
permits transfer of items from one sterile field to another, without risk of contamination
What is important when opening sterile packs?
no contact of equipment, no physical contact of skin- maintains aspepsis
circulatory nurse assists bringing equipment- in emergency
What is important when draping the patient?
sterility maintained, contamination prevented
floated over patinets
not be moved closer to incision site once placed
How far away should drapes be placed from incision site?
3/4 inch
What are towel clips?
intersect corners, pierce drape and skin- long side of table
How many drapes are involved in the drape technique?
4
2nd drape-
opposite to first
1st drape-
between patient and surgeon, edges folded under/ away from assistant
3-4th drape-
cranial and caudal
What is important when laying out an instrument trolley?
waterproof drape, followed by cloth
preformed in theatre
immediatley prior to surgery
consider time exposed to air- cover until needed
How can instruments be grouped?
type and function
What is important when handling and passing instruments?
scrub nurse has knowledge of surgery performed- ensures correct instruments avaliable
anticipate instrumentation needed
haemostasis- appropriate time
retract tissue- ensures site viability
Advise considerations for passing instruments?
positive manner, slap firmly- avoids dropping
surgeon not required to reposition
ratches open
curved tip facing upwards
thumb forceps placed into palm
How should instruments with finger rings be passed?
passed rings first
How should scalpels be passed?
consideration, sharp edge away- protects assistant and surgeon
Mounting needles-
threading of needles prior to mounting- orientation in eye, short end of suture fall away from outside curve
What are the steps considered when passing bladed items?
- passed to surgeons dominant hand, whether threaded or swaged
- needle placed in needle holder, no reposition
- right hand, needle facing left, left handed, needle facing right
When should needle holders only be used?
to place a blade onto/ remove scalpel blade
What is considered when demounting blades?
designed to hold metal, withstand stress of clamping metal blade
fingers/ forcepts mot used- injury risk
What are the swab considerations?
quantity written on autoclave packet
count amount in and out/ type
check number of swabs match
SSC!!
What is the scrub nurse’s role?
haemostasis, hydration of tissues
flushing/suction and retraction of surgical site
How is haemostasis achieved?
pressure, haemostats, ligatures and electroautery
What is systemic hydration?
IV fluids, surgical rate
what is localised topical hydration?
dry tissues/ lavage
Dry tissues- compromised circulation, impaired tissue function
Lavage- DO NOT wipe with swabs, adhesions
Healthy tissues-
handled with care, minimises trauma/ appropriate retraction/ positioning
Unhealthy/ Friable tissue-
extreme care, avoid compromising viability
