surgery light prelims

8/6/2019 Surgery Light Prelims

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OPERATING ROOMby Carrie Ann C. Beatingo, R.N.



ASEPTIC

TECHNIQUE

ASEPSIS

The absence of disease-producingmicroorganism



Two Types

of Asepsis1. Medical asepsis

Practices that limit the number of microorganismsand their growth and spread; objects are referred toas clean or dirty.

CleanDenotes the presence of some microorganismsbut the absence of infectious agents.

Contaminated or dirtyDenotes the presence of disease-producing

microorganisms



2. Surgical asepsis

Or sterile technique

Practices that keep an area or objects

free of all microorganisms

Includes practices that destroy allmicroorganisms and spores.

Two Types

of Asepsis



PRINCIPLES AND PRACTICES

OF SURGICAL ASEPSIS

1. All object used in a sterile field mustbe sterile

2. Sterile objects become unsterile whentouched by unsterile objects

3. Sterile items that are out of vision orbelow the waist level of the nurse areconsidered unsterile

4. Sterile objects can becomeunsterile by prolonged exposure toairborne microorganisms

5. Fluids flow in the direction of gravity

6. Moisture that passes through asterile object draws microorganismsfrom unsterile surfaces above or

below the sterile surface by capillaryaction7. The edges of a sterile field areconsidered unsterile

8. The skin cannot be sterilized and is

unsterile

9. Conscientiousness, alertness, andhonesty are essential qualities inmaintaining surgical asepsis



Point 2

EXIT FROM RESERVOIR

Escape route for organisms. Examples include

nose, throat, mouth, ear, eye, intestinal tract,

urinary tract, and wounds

Point 3

VEHICLE OF TRANSMISSION

Means by which organisms are carried about.

Examples include hands, equipment (e.g. bedpan),

instruments, china and silverware, linens, and

droplets

Point 4

PORTAL OF ENTRY

Part of body where organisms enter.

Examples include any break in skin or

mucous membrane, mouth, nose and

genitourinary tract

Point 5SUSCEPTIBLE HOST

Person whose body cannot fight off

organism once it enters his body and who

therefore usually becomes ill

Point 1

RESERVOIR

Place on which or in which organisms grow and

reproduce. Examples include man and animals



CLASSIFICATION OF

INSTRUMENTS

I. Cutting and Dissecting

1. Scalpels

2. Knives

3. Scissors

4. Bone Cutters

5. Sharp Dissectors



II. Grasping and Holding

1. Tissue forceps

2. Smooth forceps/T humb forceps/Pick up forceps Allisforceps

3. Babcock forceps

4. Tenaculum

5. Bone Holders



III. Clamping and Occluding

1. Hemostats

IV. Exposing and Retracting

1. Handheld Retractors

�Malleable�Hooks

2. Self-retaining Retractor



V. Suturing and Stapling

1. Needle holder

2. Staplers

VI. Viewing Instruments

1. Speculum2. Endoscopes



VII. Suctioning and Aspirating

1. Poole Abdominal tip

2. Frazier tip

3. Yankauer tip



Right Hypochondriac Epigastric Left Hypochondriac

Right lobe of liver

Gallbladder

Part of Duodenum

Hepatic flexure of colon

Upper half of right kidney

Suprarenal gland

Aorta

Pyloric end of stomach

Part of duodenum

Pancreas

Part of liver

Stomach

Spleen

Tail of Pancreas

Splenic flexure of colon

Upper half of left kidney

Suprarenal gland

Right Lumbar Umbilical Left Lumbar

Ascending colon

Lower half of right kidney

Part of duodenum and jejunum

Omentum

Mesentery

Lower part of duodenum

Part of jejunum and ileum

Descending colon

Lower half of left kidney

Part of jejunum and ileum

Right Inguinal Hypogastric Left Inguinal

Cecum

Appendix

Lower end of ileum

Right ureter

Right spermatic cord

Right ovary

Ileum

Bladder (if enlarged)

Uterus (if enlarged)

Sigmoid colon

Left ureter

Left spermatic cord

Left ovary

ORGANS IN THE 9

ABDOMINAL

REGIONS



Right Upper Quadrant Left Upper Quadrant

Liver

Gallbladder

Duodenum

Head of PancreasRight adrenal gland

Upper lobe of right kidney

Hepatic flexure of colon

Section of ascending colon

Section of transverse colon

Left lower part of liver

Upper lobe of left kidney

Splenic flexure of colon

Section of transverse colonSection of descending colon

Stomach

Spleen

Pancreas

Left adrenal gland

Right Lower Quadrant Left Lower Quadrant

Lower lobe of right kidneySection of ascending colon

Right fallopian tube

Right spermatic cord

Part of uterus (if enlarged)

Cecum

Appendix

Right ovary

Right ureter

Lower lobe of left kidneySection of descending colon

Left spermatic cord

Part of uterus (if enlarged)

Sigmoid colon

Left ovary

Left fallopian tube

Left Ureter

ORGANS IN THE

FOUR ABDOMINAL

QUADRANTS



Organize and prepares OR before the start of surgical procedure;checks to see that equipments work properly.

Gathers supplies for surgical procedure and opens sterile supplies forscrub nurseCounts sponges, sharps and instruments with scrub nurse beforeincision is made, at the beginning of wound closure, and at the end ofthe surgical procedureSends for client at appropriate timeConducts pre-operative client assessmentSafely assists client to operating table and position client accordingto surgeon·s preference and procedure type, using safety precautionsApplies conductive pad to client if electrocautery will be used;prepares client·s skin; applies ECG electrodes if needed

ROLES OF THECIRCULATING

NURSE



Explains briefly to client what the circulating nurse and scrubnurse are doing

Assists surgical team by tying gown and arranging equipmentsAssists anesthesia personnel during induction and extubationContinuously monitors procedure for any breaks in aseptictechnique and anticipates needs of the team; opens additionalsterile supplies for scrub nurse

Handles surgical specimens per institutional policyDocument on peri operative nurse·s notesCommunicates to family and recovery personnel during the surgicalprocedure

ROLES OF THECIRCULATING

NURSE



Assists circulating nurse in preparing ORPerforms surgical hand scrub, dons sterile gown and glovesPrepares sterile field with procedure appropriate supplies and

instruments; checks to make sure all work properlyCounts sponges, sharps, and instruments with circulating nurse beforeincision is made, at the beginning of wound closure, and at the end of thesurgical procedureGowns and gloves surgeons and assistants as they enter the operatingroom

Assists surgical team with sterile draping of clientKeeps sterile field orderly and monitors progress of procedure and anybreaks in aseptic techniquePasses sterile instruments and supplies to surgeon and assistantsHandles surgical specimens per institutional policy

Constantly monitors location of all sponges, sharps, and instruments inthe sterile field

ROLES OF THE

SCRUB NURSE

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