Duties or Nurse
Duties or Nurse
Duties or Nurse
• Perform assisted gowning and gloving to the surgeon and assistant surgeon as soon as they enter the operation suite
• Assemble the drapes according to use. Start with towel, towel clips, draw sheet and then lap sheet. Then, assist in
draping the patient aseptically according to routine procedure
• Place blade on the knife handle using needle holder, assemble suction tip and suction tube
• Bring mayo stand and back table near the draped patient after draping is completed
• Secure suction tube and cautery cord with towel clips or allis
• Prepares sutures and needles according to use
During an operation
End of Operation
Scrub duties
The student will be encouraged to progress from second scrub technologist to first scrub as soon as possible. The scrub
(technologist) nurse should make this judgement and assign student to first scrub. The Surgical Technology student keeps a log of
all the cases that he/she has worked with. Whenever possible, this information should be used to help assign students to a variety
of surgical specialties.
Before an operation
• Checks all equipment for proper functioning such as cautery machine, suction machine, OR light and OR table
• Make sure theater is clean
• Arrange furniture according to use
• Place a clean sheet, arm board (arm strap) and a pillow on the OR table
• Provide a clean kick bucket and pail
• Collect necessary stock and equipment
• Turn on aircon unit
• Help scrub nurse with setting up the theater
• Assist with counts and records
• Turn on OR light
• Assist the anesthesiologist in positioning the patient
• Assist the patient in assuming the position for anesthesia
• Anticipate the anesthesiologist’s needs
• If spinal anesthesia is contemplated:
Place the patient in quasi fetal position and provide pillow
Perform lumbar preparation aseptically
Anticipate anesthesiologist’s needs
During Operation
End of Operation
After an Operation
CIRCULATING RESPONSIBILITIES
The Surgical Technology student can assist the Registered Nurse with the following:
1. A five (5) minute anatomical timed scrub will be used for all surgical hand scrubs.
2. Fingernails must be free of polish/enamel and of medium length. No jewelry is permitted on the hands and arms while
performing as a member of the surgical team.
3. **Remember to put your mask on prior to starting you scrub.**
4. Wash hands and arms with solution to 2 inches above the elbow.
5. Clean fingernails with file. Take sterile brush in right hand. Wet brush with water and soap. Scrub fingernails of left
hand.
6. Start scrubbing fingers of left hand, one at a time, treating each finger as four-sided; palm, knuckles, and back of hand.
Repeat with right hand.
7. Scrub right wrist and continue up arm to 2 inches above elbow. Repeat with left arm. Discard brush. Rinse both hands
and arms under running water keeping hands above level of elbow so that water runs off the elbows and not the hands.
1. Avoid contact of sterile gloves with ungloved hands during closed-glove procedure.
2. For closed-glove method, never let the fingers extend beyond the stockinette cuff during the procedure. Contact with
ungloved fingers constitutes contamination of the glove.
3. For open-glove method, touch only the cuff of the glove with ungloved hand, and then only glove to glove for other
hand.
4. If contamination occurs during either procedure, both gown and gloves must be discarded and new gown and gloves
must be added.
5. When removing gloves after a procedure is finished, the gloves are removed after the gown is removed inside out, using
glove-to-glove, then skin-to-skin technique.
The list of treatments mentioned in various sources for Acute Gastritis includes the following list. Always
seek professional medical advice about any treatment or change in treatment plans.
• Generally will resolve of its own accord and only fluid replacement and rest needed
• Oral rehydration - water, electrolyte or gastrolyte preparation
• Anti-emetic/anti-nausea medications - e.g. metoclopramide
• IV fluids if severe case or dehydrated
• Antibiotics if severe case, fever present or septicaemic
• Medications to cease diarrhoea or slow intestinal motility are generally not recommended and can
make condition worse
• Vigilant hygiene practices (eg handwashing, care with food preparation) to prevent spread to family
and other close contacts
• Antacids, such as Mylanta or Mucaine
• H2 Antagonists
Gloving Procedure - Closed
Points to Remember about Aseptic Technique
5. Sterile persons touch only sterile items or areas; unsterile persons touch only unsterile items or areas.
A. Sterile team members maintain contact with sterile field by wearing gloves and gowns.
B. Supplies are brought to sterile team members by the circulator, who opens wrappers on sterile packages. The circulator ensures
a sterile transfer to the sterile field. Only sterile items touch sterile surfaces.
Electrical
Cautery Units, Defibrillators, OR Beds, numerous pieces of equipment
All equipment must be checked for electrical safety before use!!
Anesthetic Waste
Radiation
Leaded aprons and shields available for use during procedures.
Laser Safety
Protective eyewear for patient and operating team.
Doors remain closed with sign - "Danger, Laser in Use."
Sterile water available in the room and on sterile field.
Smoke evacuation system is to be employed when applicable.
Surgery high filtration masks should be worn during procedures that produce a plume.
General Safety
Apply good body mechanics at all times when transferring patients.
Operating room beds and gurneys will be locked before patient transfer.
Operating safety belts will be used for all patients.
Never disconnect or connect electrical equipment with wet or moist hands.
Discard all needles, razors, scalpel blades and broken glass into special identified containers.
Although the risk of contracting HIV in the healthcare setting is extremely low, there are other bloodborne pathogens which pose
a much more significant risk. Precautions should be followed to reduce the risk of exposure to bloodborne pathogens. Each
healthcare worker should assess their possible risks and take precautions to reduce these risks. Universal Precautions are designed
to protect healthcare workers from occupational exposure and should be followed when potential for exposure might occur.
Universal blood and/or body fluid precautions should be consistently used for ALL patients. Fundamental to the concept of
Universal Precautions is treating all blood and/or body fluids as if they were infected with bloodborne pathogens and taking
appropriate protective measures, including the following:
1) Gloves should be worn for touching blood and/or body fluids, mucous membranes, non-intact skin, or items/surfaces soiled
with blood and/or body fluids. Gloves should be changed after contact with each patient and hands washed after glove removal.
Though gloves reduce the incidence of contamination, they cannot prevent penetrating injuries from needles and other sharp
instruments.
2) Gowns or aprons should be worn during procedures that are likely to generate splashes of blood and/or body fluids onto
clothing or exposed skin.
3) Masks and protective eyewear should be worn during procedures that are likely to generate droplets of blood and/or body
fluids into the mucous membranes of the mouth, nose, or eyes.
4) Needles and sharps should be placed directly into a puncture-resistant leakproof container which should be as close as possible
to the point of use. Needles should not be recapped, bent, broken, or manipulated by hand.
5) Hands and skin surfaces should be washed after contact with blood and/or body fluids, after removing gloves, and between
patient contact.
6) Gloves should be worn to cleanup blood spills. Blood spills should be wiped up and then an EPA registered tuberculocidal
disinfectant applied to the area. The disinfectant should have a one minute contact time and the area rinsed with tap water. If glass
is involved, wear double gloves or heavy gloves. Pick up the glass with broom and dust pan, tongs, or a mechanical device.
7) Healthcare workers with exudative lesions or weeping dermatitis should not perform direct patient care until the condition
resolves.
Scrub Nurse/Technician
A. Preoperative
B. Preincisional
D. Closing Phase
Circulating Nurse
A. Preoperative
B. Preincisional
D. Closing Phase