Operating room

Surgical technician main responsibilities

Retracting tissue, hemostasis, managing the instrument table, lavage

Nutrition and hygiene

Eat a meal of substance, drink plenty of fluids, go to the bathroom, short fingernails (no polish or artificial nails), no perfumes

Microbial shedding

Microorganisms released into the environment from surgical personnel (sebaceous and sweat glands, hair follicles)

Proper surgical attire

Clean scrubs, head covers, mask, and shoe covers, no jewelry, no objects hanging around neck or in pockets, cover scrubs during patient prep or change them prior to entering the surgical suite

Scrubs

Should be clean (don’t wear them from home and change if wet or dirty), top should fit snugly and be tucked in (prevents body scurf), short sleeve, cover with lab coat outside of surgical suite

Body scurf

Epidermal scales being shed due to friction of rubbing against the scrub top

Head covers

All hair in the head and face needs to be covered, hair collects bacteria, dandruff

Types of head covers

Bouffant (preferred), hood, skull cap (only for short hair)

What do masks do?

Filler droplets with microorganisms from the mouth and nose

How to properly wear masks

Cover mouth and nose, tie tightly, conform to your face

How to cough or sneeze

Step back from the surgical table, don’t turn away

Proper shoes

Closed toe and heels, clean (no hair or feces stuck), covers optional

Hand scrub guidelines

Remove all jewelry, name tags, pens, stethoscope before starting; scrub is to remove as many microorganisms as possible (from hands, arms, nails); follow manufacturer directions

Surgical hand crib definition

The process of removing as many microorganisms as possible from nails, hands, and arms by mechanical washing and chemical asepsis before a person participates in a surgical procedure

Mechanical

Friction with rubbing or brushing (removes dirt, oils, and transient organisms)

Chemical

Antiseptic agent (inactivate or inhibit growth)

Can your skin be made sterile?

No, only surgically clean

Timed method

5 minutes for scrub

Stroke count scrub

10 strokes per area (around 5 minutes)

Antimicrobial agents and Alcohol-based hand rub

Non irritating, fast acting, prolonged depressant effect on residual bacteria, broad spectrum

Alcohol-based usually have moisturizer and surfactants

Antimicrobial agent

Wash hands and forearms to elbow, antimicrobial must cover the entire surface and have proper contact time, clean under nails, rinse hands and forearms with water

Pre-scrub guidelines

Remove all excess items, put on the cap and mask securing properly (can tape top of mask to avoid fogging glasses), wash and dry hands, open gown, gloves, and equipment as circulating nurse if required

How to rinse

Rinse from fingertips to elbow, always keeps hands higher than elbows, always keep arms in front of you (avoid touching your scrubs or anything around the sink)

Surgical scrub

Brush fingertips 10x (get under the nails), brush all 4 finer sides 10x (don’t forget webbing), lateral side of hand after last finger to palm, outside of thumb and side of hand (finish thumb), base of fingers to wrist, wrist to elbow 10x on each side, same process for other arm

Antimicrobial rub agent

Wash hands and forearms with soap and water, clean subungual area (under nails) and rinse, dry thoroughly, dispense produce onto palm, start with fingers to hand to wrist to forearm (same as scrub)

Hand drying

Pick up sterile towel from the corner, don’t drip water onto the gown, step back from the table, fully open the towel by letting it hang, using one end of the towel gently rub to dry hand in a circumferential pattern (finger, hand, arm), bend wrist slightly to avoid the towel touching your scrubs, use opposite end of the towel to dry other arm, drop towel on floor, keep hands above waist level

Gowning

Lift the gown from table, step back and allow ample space, locate neckline and armholes, hold neckline and allow gown to unfold, place hands in arm holes, slide both arms in by reaching and extending both at the same time, circulating nurse will help adjust and tie you in, keep hands in cuffs

What does closed gloving do?

Create a barrier between sterile and nonsterile

Closed gloving

No bare skin exposed, with left hand pick up right glove by folded cuff, place glove over right palm (palm facing up and glove palm is down), grasp cuff through the gown cuff and pull glove over with left hand, repeat with left hand, adjust gloves over gown cuffs

When is Open gloving used

Shouldn’t be used for surgical gloving, used to replace a contaminated glove, done when only hands need to be sterile, hands are expressed

Open gloving technique

Left hand picks up right glove (only touching inside), gently glide hand and fingers into glove, don’t adjust cuff yet, place fingers of gloved hand inside the folded over cuff, pull glove on as before, slide fingers of left hand into cuff of right glove to adjust cuff

Assisted gloving

A sterile person helps a scrubbed in person change gloves, contaminated glove is removed by grasping the outside of the glove cuff avoiding the gown, pull glove off inside out, gown cuff shouldn’t be pulled over hand (it’s contaminated), sterile person picks up the glove and puts the fingers of both hands inside the glove cuff stretching it widely, pull glove completely over the cuff

Responsibilities once scrubbed in

Maintain sterility, assisting the surgeon, managing the instruments, passing instruments, retraction, hemostasis

Ways to avoid fainting

Don’t lock your knees, eat a meal, drink water, shift weight from leg to leg to assist with blood flow and stay alert