Surgery Assisting (Scrubbed-in)

Question 1

Responsibilities of the scrubbed in Sx assistant (7)

Answer 1

1. Proper instrument passing
2. Setting up & maintaining instrument (back) table
3. Assist surgeon w/tissue positioning & visualization
4. Organized table allow instrument ID & passing quickly
5. Assist with hemostasis & suctioning
6. Maintain tissue moisture
7. Performing instrument & sponge counts prior to surgery close

Question 2

How to pass a loaded scalpel handle (2)

Answer 2

1. Blade pointed towards assistant, with cutting edge away from the hand
2. Thumb & index finger should hold the handle with the hand in a supinated position. Place into the webbing of the surgeons hand.

Question 3

Suture needles loaded onto needle holders (4)

Answer 3

1. Needle holders placed 2/3rds into needle curve for secure & controlled handling
2. Suture passed from inside of curve to outside
3. Remember surgeons dominant hand
   - RH: needle face left, vice versa
4. Place in hand so needle holder can be immediately used

Question 4

Ringed instrument passing (3)

Answer 4

1. Instrument should be closed to the first ratchet
2. Ring handles facing the floor & tip to the ceiling
3. Box lock hold between the thumb & index finger with the remaining being supported by the rest of your fingers.

Question 5

T/F: With curved tipped instruments, the curved part should face the thumb of the surgeon once it is placed in their hand

Answer 5

True! This way the instrument is ready to use

Question 6

Passing instruments without ring handles (2)

Answer 6

1. Hold instrument facing the floor
2. Other end should be held firmly with thumb & index finger, while the remaining fingers stabilize the instrument

• Now the instrument is ready to use!

Question 7

T/F: Handling healthy tissue doesn’t require a lot of care as opposed to unhealthy tissue, which needs extreme care

Answer 7

False! Healthy tissue should be handled carefully to avoid trauma, same goes for unhealthy tissue (but with even more care!)

Question 8

What should go between the patient and retractors during Sx to help avoid trauma to the tissues?

Answer 8

Lap pads

Question 9

How to keep body tissues moist (5)

Answer 9

Supplies:
1. Sponge bowl
2. Single gauze soaked
Directions:
3. Squeeze gauze while suspended above drip lavage
4. NO wiping or rubbing tissue!! Friction = adhesions
5. Bowl should be kept where it will not spill & contaminate

Question 10

T/F: Isotonic solution can be used as lavage to keep tissues moist

Answer 10

True

Question 11

T/F: LRS or 0.9% NaCl are great to give as IV fluids during a surgery

Answer 11

True

Question 12

In the scenario a vessel is cut during Sx, what should the assistant do?

Answer 12

1. Ready to pass hemostats (& pass them)
2. Blot hemorrhage before surgeon palces hemostat
3. Blot, not wipe. Wipe may cuase coagulation to be removed
4. Apply firm pressure
5. Soaked sponge can be used to estimate how much blood loss there was

Question 13

Gauze square absorption:
3x3 = ___mL
4x4 = ___mL

Answer 13

3x3 = 6mL
4x4 = 10mL

Question 14

When using a suction machine, the ___ suction tip is attached to a ___ hose. The other end of the hose is handed to __-___ assistant by the surgeon to attach it to the suction unit.

Answer 14

1. Sterile
2. Sterile
3. Non-sterile

Question 15

What are four Sx’s that a suction machine is extremely useful to use during?

Answer 15

1. Intestinal
2. Abdominal
3. Exploratory
4. Bladder

Question 16

Post op suction machine cleaning (3)

Answer 16

1. Clean all blood/debris from tubing & tip in cold water.
2. With warm water, flush tubing and tip. Clean hold jar well.
3. Allow to dry then re-sterilize

Question 17

Cautery & suction are secured with ___ ___ forceps to the drape approximate to the Sx field

Answer 17

Allis tissue forceps

Question 18

Sx assistant is responsible for the instrument count. This should happen at the ____ and ___ of surgery. Circulating assistant will help with this duty.

Answer 18

Beginning & end of surgery

Question 19

T/F: The only sponges that need to be counted at the end of surgery are the ones used

Answer 19

False! You must count all the used sponges (in the trash, floor, etc) AND the ones not used. This way you will end up with the same number in the initial count.