3-2. PREPARATION OF THE OPERATING ROOM
a. The circulator should check the operating room schedule the day before surgery for any changes that may have been made. The operating room specialist should be in the assigned room in plenty of time to prepare for the surgical procedure. Centralized Materiel Service should be notified of any special equipment and/or instruments that may be needed for the case that are not readily available.
b. Personal cleanliness is extremely important for the operating room specialist. Before performing the duties described in the following paragraphs for preparation of the operating room, the circulator should wash his hands thoroughly and don a surgical hat. The surgical cap must cover the hair completely to prevent possible contamination of the sterile area by falling hair or dandruff. He should then don a clean, cotton scrub suit before entering the semi-restricted areas of the surgical suite. Before entering a restricted area, the OR specialist must don a surgical mask per local SOP. The mask protects the patient from bacteria exhaled by operating room personnel. The mask must fit snugly around the nose and mouth to filter the air through it rather than around the sides of the mask. The mask should be changed whenever it becomes damp and after each procedure. Now you are ready to prepare the operating room for surgery.
c. Damp dust the operating room unless this has already been done by personnel on the previous shift. Concurrent with dusting, check equipment, arrange furniture, and restock supplies. After damp dusting with a cloth soaked in disinfectant solution prescribed by local policy, wet vacuum the floor using a disinfectant prescribed by local policy. Dry dusting and mopping is never done in the operating room because it raises dust that contains bacteria.
d. Check with the scrub for any special equipment he may need for the case.
e. If the instruments were not wrapped and sterilized on the preceding shift, ensure that instrument sets are placed in the autoclave.
f. Check that all equipment needed to position the patient is in the room. If not, get the necessary equipment.
g. Discuss with the scrub the sterile supplies needed for the case (be sure to discuss the kind and amount of sutures needed) and then bring the supplies into the room. The surgeon's preference card will list the types and sizes of sutures needed for the procedure.
h. Place sterile goods on the tables or stands where they will be used to avoid having to move them from one place to another. You should place the various sterile items as indicated in (1) through (6) below.
i. Put sterile packages that the scrub will not need immediately (such as suction tubing and culture tubes) on the utility table and open them after the scrub has prepared a space for them. You may also place on the utility tables supplies needed from the sterile supply cabinets such as knife blades, needles, etc.
j. Do not place sterile supplies on the operating table nor on the anesthetist's equipment (the anesthesia apparatus and the anesthetist's table) because these areas are for the use by the anesthetist only.
k. Open the sterile supplies. Before any sterile supplies are opened, however, the integrity of every package is checked for tears, punctures, watermarks, expiration date, and the sterilization indicator. Tears, punctures, and watermarks on a sterile pack indicate that the supplies are unsafe to use. The sterilization indicator shows whether MD0935 3-5 the pack has been through the sterilization process. The date of expiration will tell you whether it is too old for safe use. If the package is in any way compromised, it must be discarded and a new pack secured.
l. Open the packs and sets in the order in which the scrub will need them. Open the sterile gown first; the scrub will need this immediately upon entering the room.
m. All sterile wrappers are to be removed in the same general manner. Open the wrapper so that your hand and arm do not pass over any part of the inside of the wrapper that has been exposed.
n. Larger sterile supplies can be opened using the wrappers to form a sterile field and are to be opened in the following manner.
(1) With hands on the outside of each wrapper in a folded cuff, always lift the wrapper toward you to avoid contaminating the contents of the pack (see Figure 3-6). The area touched by you under the cuff falls below table level and the inside of the wrapper remains sterile.
Figure 3-6. The circulator beginning
Figure 3-7. The circulator bringing the to open a sterile pack. second fold over the end of the table.
o. Smaller sterile supplies are to be opened and added to the sterile field in the following manner:
Figure 3-8. Open sterile package.
Figure 3-9. Hand enclosed by wrapper.
Content Providers: The U. S. Army, The U.S. Navy
Ancillary Content and Online Version: David L. Heiserman
Publisher: SweetHaven Publishing Services
Copyright © 2001, 2004 SweetHaven Publishing Services