General operating procedure in the operating unit
Operating must be ready for operation at any time of the day: covered tool table, prepared the necessary equipment in the cabinet should be kept all the necessary medicines and solutions.
Permitted shelf life of sterile clothes and tools for three days, but we should strive to change the duty set daily.operational work is organized as follows.
1. On the eve of the operating spend cleaning.
2. Check whether the selected tools and the day before embarking on their sterilization.
3. A nurse checks the availability of all necessary instruments in the operating room, arranged the furniture, makes the operating table and the lamp position.
4. Then sister dresses, puts on operating clothes.
5. Hand Treatment for operation.The pre-check carefully whether the removed hair and cut nails, sister double washes her hands with soap and water, taking out slut sterile mask and puts it on, covering the nose and mouth.Processes hands one of antiseptics.
Processing surgeon and a nurse hands
based hand antiseptic
Gibitan available as a 20% aqueous solutionin vials of 500 ml.Shelf-life of the drug, the 3 Working Chlorhexidine solution is prepared daily use in any dish.For the treatment of hands using 0.5% ethyl alcohol solution (at a dilution of 1:40) in 70% ethanol and 1% (at a dilution of 1:20) aqueous solution prepared by diluting the initial 20% solutionin distilled water: 500 ml 20% solution per 10 liters of water.Hand processing is done with a cotton swab dipped in this solution for three minutes, then wipe dry with a sterile towel.Chlorhexidine is quickly passing stickiness hands.At the use of chlorhexidine can not use the iodine and iodine-containing antiseptics due to the risk of dermatitis.
Tserigel - clear, colorless, viscous liquid.Available in bottles of 400 ml.The preparation entered the film former, due to which the film is formed during processing tserigelya hands.For dry skin is applied 3-4 g tserigelya and within 8-10 triturated with that solution covered the palm and back of the fingers and hands, interdigital spaces and the lower third of the forearm.Hands were dried in air or under the fan during drying fingers should not touch each other and being slightly bent.drying time of the film can not be cut, as this can result in slipping.Gloves do not apply.After the operation film tserigelya easily removed with alcohol.
Degmin - solid waxy substance yellowish-white in color, readily soluble in water to form a thick, rigid foam.Available in bottles of 500 ml.Degmitsid - liquid containing 30% degmina.For the treatment of hands using a 1% solution degmina, which degmitsid diluted ordinary boiled water in the ratio 1:30.Hot water accelerates the dissolution of the drug.The bactericidal solution stored for 6 months.Hand treatment is performed by rubbing two sequential swabs soaked liberally solution formulation for 3 min.When reprocessing hands rubbed a swab for 3 minutes.After processing
hands, scrub nurse goes to the operating room.The nurse opens the lid of sterile slut with bathrobes.Operating sister slut takes out a folded gown, unwraps it, making sure that the outer surface of the sterile gown touched the neighboring objects.It is best to immediately vdet both hands in the sleeves of his robe, and throw it on the front.Nurse pulls robe behind the edges and ribbon tying.Sister pulls from his pocket a bathrobe belt, keeping at a distance of 30-40 cm from himself so that the loose ends hanging belts.A nurse takes care belt ends and without touching the sterile gown, gets back and ties.The ribbons on the sleeves scrub nurse tying itself or helps her other sister, to prepare for the operation.
nurse pulls out slut gloves.The edges of the glove turns away outwards in the form of cuffs, thumb and forefinger of his right hand grasps the left edge to turn away the gloves and pulls it to the left hand.Stunt left hand (gloved) brings under the lapel of dorsum of the right glove and pulls the latest on his right hand.Without changing the position of the fingers and loosen the edge of gloves folded into place.The edges of the gloves must be placed on top of the laces coat sleeves.Then sister takes a big ball, heavily soaked in alcohol, carefully wipe off his gloves.Hand in sterile gloves should be kept bent at the elbows and raised a little above the waist.If, for some reason, the operating surgeon and sister waiting is not busy, then the gloves on his hands to protect it from air infection should be wrapped with sterile gauze, cloth moistened with 96% alcohol.
After putting on sterile gown and gloves, scrub nurse can begin covering the operating table.
Operating sister must calculate the time so that the instruments were laid out on a large table for 20 minutes before dressing surgeon.From the laundry slut sister pulls out the sheet and covers it in two layers of large tool table.The second sheet puts it in such a way that one half of it covered the table, and the second roller was rolled on the far edge of the table.It is necessary to further close the tools disposed on the table.
Sister examines the tools and the tool lays out the middle of the table.Each type of instrument is given its place, and the tools used most often placed close to the edge of the table.The right edge of the table do not cover the top sheet and used to accommodate wide mouth jars with antiseptic and sterile tray with an antiseptic solution, which contains a scalpel and needle.The tray put sterile forceps or long tweezers for grasping the desired object and transferring it to the small table.
Suture unnecessarily should not be removed from the cans in which it is stored.
Sterile sets for blood transfusion and tracheotomy should be stored separately, wrapped in sterile sheets.
When all the tools laid out, covering their sister sheets folded in half, and its edges should hang from the table edges, the corners should be imposed clamps.
Once on the large table all prepared, scrub nurse lays out the tools in the tool table, which had previously been covered with sterile sheets in two layers;the edges of the sheets must hang far over the edge of the table.On the second sheet is placed in such a way that one half of its tools could cover.Operating room nurse shifts forceps necessary tools with a large tool table on small and arranges them in a strict order.Do not put a lot of tools, as it interferes with the sisters and the surgeon.
Depending on the position of the operating table's sister - the right of the operating table (next to the surgeon) or left of the table (next to the assistant), - tools have two ways (from right to left or left to right).
If the sister is the right of the surgeon, on the right edge of the table by operating Sisters lie napkins in three packages - behind the big swipe, then medium and small.On the front edge of a tools constantly needed a surgeon.Tools from the front edge of the table take himself a surgeon and an assistant, and my sister only the maintenance of order on the table, and restores the proper placement of instruments.The rear edge of the table is at the disposal of the operating surgeon and his sister does not apply.There are arranged replacement tools, ready to work, but are not required at this time, the suture and surgical nurses, through which it cuts the strands of desired length shears.Operating sister has no right to touch the instruments used and stained with blood;in an extreme case, it removes their forceps.
At least carry suture material.
In the left corner of the suture is placed in the right - tools necessary for local anesthesia.
Usually tools are laid out in three rows:
• in the front row have the best driving tools (scalpels, scissors, hemostats, needle holders, forceps);
• in the 2nd row - the tools that are needed specifically for this operation;
• in the 3rd row - a rare instruments and duplicates.
After my sister is ready for operation, it helps the surgeon.The surgeon handles arms, and sister helps him put on a dressing gown.
Nurse gives a detailed surgical gown so that he could immediately push both hands in the sleeves, and then discards the top edge of the robe on his shoulders.The nurse behind the ribbon ties and a belt.After donning his robe on a sterile mask change: it takes the mask sister, holding her fingers over the ends of ribbons, ties nurse them back on his head.