Surgical Instruments

Question 1

What is a mayo stand?

Answer 1

It is a portable instrument stand with adjustable height. It is framed with removal tray and can be placed near the sterile field. It also contain immediate need instruments and supply.

Question 2

What are the five different instruments classifications?

Answer 2

Cutting, grasping/holding, suturing, retracting and miscellaneous/ specific use

Question 3

What supplies are classified under the cutting instruments?

Answer 3

Scalpels - Bard Parker (BP) holder

Saw, diathermy pen and surgical laser beam

Scissors - fine/heavy/various length/straight/curved/angled

Mayo scissors - to cut sutures
Metzenbaum scissors - to cut delicate tissues

Question 4

What supplies are classified under the grasping/holding instruments and their purpose? #1

Answer 4

Dissecting forceps

• Toothed/ Non-toothed
• Various length
• Fine/ Heavy

Purpose is to hold/grasp tissue for suturing or diathermy

Question 5

What supplies are classified under the grasping/holding instruments and their purpose? #2

Answer 5

Tissue forceps

• Allis, babcock, littlewood, stillies
• Usually occurs in sets of 2

Purpose is to hold/grasp tissue or peanuts/swabs

Question 6

What is the use for artery forcep?

Answer 6

Various length, fine/heavy, set of 6, 10, 12.

Close at first ratchet and the purpose is to hold the tissues/ hemostasis

Question 7

What supplies are classified under the retracting instruments and their purpose?

Answer 7

Hand held retractor - various length

Self sustaining retractor - detachable and non detachable

The purpose is to retract tissue and expose operation site

Question 8

What supplies are classified under the suturing instruments and their purpose?

Answer 8

Needle holder

• Various length
• Crilewood (fine) - for fine needle
• Mayo (heavy) - for thick needle

Usage is to hold the needle for suturing and blade applicator for heavy needle holder

Question 9

What supplies are classified under the miscellaneous instruments and their purpose? #1

Answer 9

Sponge holders

• set of 2’s
• Rampley sponge holder

Usage: skin preparation and swab on stick

Question 10

What supplies are classified under the miscellaneous instruments and their purpose? #2

Answer 10

Towel clips

• Various type
• Set of 4’s and 6’s come in pairs

Usage: Secure drapes, diathermy and suture tubing
Do not readjust once applied - contaminated

Question 11

What supplies are classified under the miscellaneous instruments and their purpose? #3

Answer 11

Suction ends/ tips

• Various length/size
• Mental/ disposable

Usage: Remove fluid or blood

Question 12

Care of instruments during surgery

Answer 12

1. Account for each instruments in the instrument checklist and count chart
2. Familarise
3. Inspect before and after use
4. Avoid throwing, dropping or stacking
5. Remove used instrument promptly from the surgeon
6. Keep instruments clean
7. Protect from sharp edges
8. Do not remove the instruments from OR

Question 13

What are the guidelines for coutning instruments?

Answer 13

1. Scrub nurse and circulating nurse to account jointly
2. Count audibly and systematically
3. Account for broken parts
4. Account for additional instruments - record in count chart
5. Documentation - instrument checklist

Question 14

What are the risk factors for count discrepancies?

Answer 14

1. Intial count (manufactory mispacked +/-)
2. Patients who underwent emergency operation
3. Complex surgery with multiple devices used simultaneously
4. Multi-tasking, distraction, unexpected interruption, time pressure, high stress environment
5. Retained swabs and instruments is also increased in a person with high BMI