Intraoperative phase & Principles of Surgical Asepsis

The surgical Team

— Consists of the patient, the anesthesiologist or anesthetist, the surgeon, nurses, and the surgical technologists (or assistants).

The Circulating Nurse

— A qualified registered nurse, works in collaboration with surgeons, anesthesia providers, and other health care providers to plan the best course of action for each patient.

— Main responsibilities include verifying consent; coordinating the team; and ensuring cleanliness, proper temperature, humidity, lighting, safe function of equipment, and the availability of supplies and materials.

— monitors aseptic practices to avoid breaks in technique while coordinating the movement of related personnel as well as implementing fire safety precautions. The circulating nurse also monitors the patient and documents specific activities throughout the operation to ensure the patient’s safety and well-being.

Scrub Nurse

— performing a surgical hand scrub; setting up the sterile tables; preparing sutures, ligatures, and special equipment; and assisting the surgeon and the surgical assistants during the procedure by anticipating the instruments and supplies that will be required, such as sponges, drains, and other equipment.

Registered Nurse First Assistant

— Scope depends on the state’s nurse practice act

— practices under the direct supervision of the surgeon.

— responsibilities may include handling tissue, providing exposure at the operative field, suturing, and maintaining hemostasis.

The unrestricted zone

— where street clothes are allowed

The semi restricted zone

— where attire consists of scrub clothes and caps

The restricted zone

— where scrub clothes, shoe covers, caps, and masks are worn.

20c - 24c

Temp

30%-60%

humidity

Malignant Hyperthermia

— an inherited muscle disorder chemically induced by anesthetic agents.

— With the mortality rate exceeding 50%

— Susceptible people include those with strong and bulky muscles, a history of muscle cramps or muscle weakness and unexplained temperature elevation, and an unexplained death of a family member during surgery that was accompanied by a febrile response

Disseminated Intravascularcoagulopathy

— Is a life-threatening condition characterized by thrombus formation and depletion of select coagulation proteins.