SRG 140 Principles and Practices of Surgical Technology

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SRG 140Principles and Practices of Surgical
Technology

• Preoperative Case Management
• Lecture 140-3

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Joshua Loth Liebman

• God hears no sweeter music than the cracked
  chimes of the courageous human spirit ringing in
  imperfect acknowledge of His perfect love.

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Text

• Surgical Technology, Principles and Practices,
  Chapters 9 and 15

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Objectives

• Apply the three principles of asepsis to the
  practice of sterile technique
• Identify the correct set-up of a surgical case
• Identify methods to open surgical supplies
  correctly
• Identify the use of various supplies and
  accessory supplies in the operative environment.

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General Case Planning

• Preoperative diagnosis
• Procedure planned
• Previous surgeries in the same area
• Radiographs available or needed during case
• Patient position
• Draping
• Age and general condition
• Size of patient
• Level of consciousness and sensory alterations
• Incision to be used
• Special equipment require
• Drugs needed
• Wound classification
• Drug or latex allergy status and Infection status
  of patient

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Preoperative Case Management

• Preparing nonsterile equipment
• Arrange room furniture
• 18 from a nonsterile surface
• Clean linen on OR table with all attachments for
  the table are present
• Connect suction tubing to canisters
• Gather needed dx studies
• Assist anesthesia if needed
• Tanks for power equipment in room and full

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Opening Sterile Supplies

• STPP Pages 296 and 297
• Check the integrity of each package before
  opening (tears or watermarks)
• Open heavy items first, smaller items on top
• Check the external chemical indicator tape to be
  certain the item has been exposed to a
  sterilization process
• Remove tape from packages wrapped in woven fabric
  wrappers
• Tear tape on plastic or nonwoven wrappers
• Stand close enough to accurately project the item
  onto the sterile field

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Envelope Fold

• Surgical Technology, Principles and Practices,
  Chapter 9 Pages 146 and 147

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Square Fold

• Surgical Technology, Principles and Practices,
  Chapter 9 Pages 144 and 145

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Opening Supplies

• Basin sets
• Small items
• Instrument sets
• Peel-packs

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Pouring Solutions

• Pour the solution directly into a container set
  close to the edge of the back table
• Pour the solution into the container being held
  in the hand of the scrub person
• Empty the entire container keeping the bottle
  pointed downward as you move away
• After the bottle has been opened and its contents
  poured, the lip of the bottle is no longer
  considered sterile

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Organization of Equipment

• Increase the size of the sterile working area
• Avoid shifting items around from one place to
  another
• Try to avoid doing several things are once
  perform one task and then proceed to the next

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Preparation of the Sterile Field

• A logical and efficient pattern must be
  established and repeated during preparation for
  all types of surgical procedures
• Contamination, product differences, surgeons
  preference, the patient situation, and policy
  might cause variations
• Plan in advance the steps that will be taken when
  a variation does occur

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Preparation Steps

• Dressing the mayo stand
• Organizing the back table
• Pouring the fluid
• Filling a bulb syringe
• Removal of the instrument set from the container
  system
• Assisting a team member
• Draping the patient
• Positioning of the sterile team members and the
  furniture

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Setup

• Distribute towels, gowns, gloves, and drapes
• Prepare light handles, suction tubing, and bovie
• Prepare knife and basic instruments
• Organize sponges, sutures, and small counted
  items
• Stack remaining linen and drapes

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Priority Setup

• Towels are distributed to team members, and they
  are gowned and gloved
• The patient is prepared
• The patient is draped
• Suction tubing and the electrosurgical pencil are
  set up
• Sterile light handles are attached
• Two sponges are placed on the field
• The incision is made