2 The Technician’s Role in the Surgery Room Important assistant to the surgeon:Retract tissueLavage surgical field with sterile fluidManage instrument table
3 Nutrition, Hygiene, and Appearance Eat a meal of substance before surgeryComplex carbs and proteinGroom fingernailsAvoid cologne and perfumesome people are sensitiveMay mask important odors
4 Types of Contamination EndogenousFrom the patient itselfExogenousFrom surgical team or environment
5 Proper Attire in Surgical Area Microbial shedding of microorganisms from humans can be prevented by:Freshly laundered scrub suitsHead coversMasksPerhaps shoe coversFollow written and posted dress code
6 Scrub Suit No street clothes Don’t wear scrubs from home into work Freshly laundered in clinicFit snug to body; shirt tucked into pantsClean lab coat over scrubs if stepping out of surgery area
7 Proper Attire Scrub top tucked snuggly into the pants This prevents body scurffrom beingshed
8 (im-)Proper attire This skull cap head cover This bouffant is a proper does not fit snuglyand leaves hairexposed.This bouffant is a properhead cover for thistechnician
9 Masks and Shoes Mask: over mouth and nose If about to sneeze, don’t turn head; step out of sterile fieldShoes: comfortable and clean; can use shoe coversFoot attire has no proven significance in reducing the incidence of post-op wound infectionsShoe covers used to reduce floor contamination
10 Jewelry and Fingernails Jewelry: all should be removedCan harbor microorganisms that routine hand washing cannot removeEarrings, necklaces, bracelets, and body piercings could fall into the surgical fieldFingernails: clipped to below fingertips; no nail polish
11 Surgical Hand Scrub and Hand Rub Hand scrub: remove as many microorganisms as possible from the nails, hands, and arms using mechanical and chemical antisepsisSkin is never made “sterile” but rather surgically clean
12 Surgical Hand Scrub and Hand Rub Timed vs. stroke method: 5 min minimumFor both methods follow an anatomical patternFingers, fingertips, hands and arms; each have four sidesSubsequent scrubs of the day can be 2-3 minAntimicrobial scrub agents:FDA-approved hand scrubs oralcohol-based rubsBrushless techniqueStandardized protocol in scrub room
13 Scrub Solutions Ideal characteristics: FDA compliantBroad spectrum of activityFast acting and effectiveNon-irritatingPersistent effects and cumulative activityFollow manufacturer’s written directions for use
15 Prescrubbing Guidelines Remove rings, watches, jewelry, name tags, pens from top pockets, and so on.Wash hands and forearms with antimicrobial scrub and running water.Clean subungual areas using disposable nail-cleaning pick.Keep hands above elbows to allow water to run off.
16 Prescrubbing Guidelines Don’t touch anything.Apply antimicrobial agent to wet hands and forearms.
17 Scrubbing GuidelinesBrush each fingertip 10 times; go under fingernails.Sides of fingers, beginning with the lateral side of each.Webbing between the fingersLateral side of the handPalmOutside of the thumbBase of the fingers to the wristForearms to elbowThen rinse
44 Assisted GlovingWhen a sterile team member helps another scrubbed-in team member gloveCuff of gown should not be pulled over the hand
45 Contaminated GownCirculating nurse unfastens it and pulls it off (inside out) from the team member who was contaminated.Contaminated person removes gloves and pulls them off inside out.Sterile sleeves can be used.
46 Remain AlertAvoid locking knees when standing for long periods of time.Eat before scrubbing in.Slowly shift weight from leg to leg.