1. Organizing the Sterile Field, Draping the Mayo Stand, & Counting
Concorde Career College

2. Objectives
Describe the technique utilized when dressing the Mayo stand and explain the related sterile concepts.
Outline an efficient pattern utilized to organize the sterile field.
Describe the technique utilized when removing an instrument set from a container system.

3. Objectives
Describe the technique utilized when filling a bulb syringe and explain the related concepts.

4. Organizing the Sterile Field and Dressing the Mayo Stand
Define the term don.
Define the term dress.
What is the difference?

5. Organizing the Sterile Field and Dressing the Mayo Stand

6. Organizing the Sterile Field and Dressing the Mayo Stand

7. Organizing the Sterile Field and Dressing the Mayo Stand

8. Organizing the Sterile Field and Dressing the Mayo Stand

9. Organizing the Sterile Field and Dressing the Mayo Stand
Troubleshooting
If the cover will not move forward – STOP PUSHING it!
Slowly unfold
Do NOT let the cover drop below the level of the sterile field.
Use your foot to stabilize the Mayo stand

10. Organizing the Sterile Field and Dressing the Mayo Stand

11. Organizing the Sterile Field and Dressing the Mayo Stand

12. Organizing the Sterile Field and Dressing the Mayo Stand
Place one sterile towel (or two depending on procedure or preference) over the top of the Mayo stand.
Place one rolled towel in the desired position (Use the A POSitive CARE approach to determine the location of the towel.)
A POSitive CARE approach to surgical problem solving that concentrates on the ability of the surgical technologist to predict the patient’s and surgeon’s needs through the intraoperative period. The goal is for the surgical technologist to apply this model in daily practice for maximum efficiency and effectiveness during the surgical procedure.

13. Organizing the Sterile Field and Dressing the Mayo Stand
Organization of the Sterile Field
Conserve time and motion
Keep your hands over the back table
Place each item in its final destination the FIRST time you touch it and DON’T touch it again!

14. Organizing the Sterile Field and Dressing the Mayo Stand
Work in one small area at a time
Step away only to retrieve additional items and then return to small working area
Place items in the same arrangement for every case
Place items for easy counting

15. Organizing the Sterile Field and Dressing the Mayo Stand
View of sterile field with all supplies open

16. Organizing the Sterile Field and Dressing the Mayo Stand
Close up view of Mayo stand with towel, gown, and gloves for the STSR

17. Organizing the Sterile Field and Dressing the Mayo Stand
Close up view of back table – note that supplies have been added to the back table near the intended area of use

18. Organizing the Sterile Field and Dressing the Mayo Stand
Close up view of basin set

19. Organizing the Sterile Field and Dressing the Mayo Stand
Close up view of instrument set (minor tray)

20. Organizing the Sterile Field and Dressing the Mayo Stand
Dress the Mayo stand
Mayo cover in position
Towels in position
Several variations are available – learn from your preceptors

21. Organizing the Sterile Field and Dressing the Mayo Stand
Even though the Mayo stand has been draped, note that the back table organization has not changed
Compare to slide #16
Mayo stand cover and towels were removed from back table without disturbing (moving) other items

22. Organizing the Sterile Field and Dressing the Mayo Stand
Items from the basin set that are to be positioned on the back table are in place but the original items on the back table have not been disturbed (moved)

23. Organizing the Sterile Field and Dressing the Mayo Stand
Basin set with items that are to remain in the basin set
Light handle covers (separated)
Suction tubing and tip (packaging material removed and properly connected)
ESU pencil (packaging material removed)

24. Organizing the Sterile Field and Dressing the Mayo Stand
Basin set with draping supplies added
Laparotomy sheet and four drape towels

25. Organizing the Sterile Field and Dressing the Mayo Stand
Back table with draping supplies removed

26. Organizing the Sterile Field and Dressing the Mayo Stand
Basin set with gloves, gowns, and towels for additional sterile team members added Items are placed in the basin set in the reverse order of use!
This is the reverse order of use! WRITE IT DOWN
Suction (connected and properly curved), ESU pencil (packing material removed), and light handle covers (packing material removed and separated)
Laparotomy sheet
Four drape towels (prepared – 3 toward, one away, and fan folded)
Towel clips, if desires
Gloves for the surgeon and assistant
Gowns for the surgeon and assistant
Towels for the surgeon and assistant

27. Organizing the Sterile Field and Dressing the Mayo Stand
Back table following dressing the Mayo stand and basin set organization
Other minor adjustments to the back table have been made

28. Organizing the Sterile Field and Dressing the Mayo Stand
Close up of right side of back table
Note position of sponges (strings in)
Suture organized in order of use (according to preference card)
Suture (trash) bag (refer to AST recommendation)

29. Organizing the Sterile Field and Dressing the Mayo Stand
Work with circulator to ensure that the inside of the tray is dry and the filter is intact

30. Organizing the Sterile Field and Dressing the Mayo Stand
Instruments organized on back table
Note:
Like items together
Ready to count (count prior to organizing Mayo stand)
**Make sure students are placing at least one towel under instruments when setting up (though not depicted in this image). Students must also practice making roll towels.

31. Organizing the Sterile Field and Dressing the Mayo Stand
Perform the initial count before moving items to Mayo stand!

32. Organizing the Sterile Field and Dressing the Mayo Stand
Mayo stand organized for use (front view)
Have the students list (or draw) the items

33. Organizing the Sterile Field and Dressing the Mayo Stand
Mayo stand organized for use (side view)

34. Organizing the Sterile Field and Dressing the Mayo Stand
View of instrument set following organization of the Mayo stand
Compare to slide #28

35. Organizing the Sterile Field and Dressing the Mayo Stand
Attend to as many details in advance as possible
Note suture loaded on needle holders

36. Organizing the Sterile Field and Dressing the Mayo Stand
Detail – towel clips place near draping material for possible use

37. Organizing the Sterile Field and Dressing the Mayo Stand
Expel air
Maintain pressure on bulb
Place in liquid
Release pressure on bulb to draw liquid into syringe
Repeat as needed
Use caution not to expel liquid contained in syringe

38. Organizing the Sterile Field and Dressing the Mayo Stand
Filling the Bulb Syringe
Remember – This is NOT a squirt gun!

39. Organizing the Sterile Field and Dressing the Mayo Stand
Counting
Preop on pg. 342 see table 12-1, , pg. 346
Intraop pg. 386 see table 12-21
Review technique box on pg. 347
Have items to demo count.
AST RSOP

40. Organizing the Sterile Field and Dressing the Mayo Stand
What is the importance of counting instruments, sponges, sharps, and incidental items?

41. Organizing the Sterile Field and Dressing the Mayo Stand
What is meant by the term incidental items?
Stuff other than instruments, sponges, and sharps. Bovie scratch pad, FRED, etc.

42. Organizing the Sterile Field and Dressing the Mayo Stand
How many counts are needed for each procedure? When are the counts performed? Are there any exceptions?
Initial count before case, Additionally as needed, Team changes, Closing count 1 of all stuff (peritoneum), Closing count 2 (fascia) Final Count (skin)

43. Organizing the Sterile Field and Dressing the Mayo Stand
Who is responsible for counting? How?

44. Organizing the Sterile Field and Dressing the Mayo Stand
What is the counting procedure?

45. Organizing the Sterile Field and Dressing the Mayo Stand
What happens if additional items are added to the field during the procedure (after the initial count)?
Pg 386

46. Organizing the Sterile Field and Dressing the Mayo Stand
What if… The count is incorrect?
Pg. 387
Table 12-21