💚Chandigarh Call Girls Service 💯Jiya 📲🔝8868886958🔝Call Girls In Chandigarh No...
presentation1-140615135842-phpapp02.pptx
1.
2. TABLE OF CONTENTS:
Defination of a scrub nurse
Specific role in OR
Responsibilities of a scrub nurse
Video on ASEPTIC TECHNIQUES
Orientation on SURGICAL NEEDLES
Orientation on SURGICAL SUTURES
Orientation on SURGICAL INSTRUMENTS
Video on INSTRUMENT HANDLING
4. To prepare and drape
sterile drapes,instruements
& supplies
To assist surgeon &
assistants throughout
operation by providing
instruements & supplies
To maintain patient’s safety
throughout operation
5. • Welcoming patient to OR
• Preoperative nursing assesment
• Checklist before scrubbing
• Scrubbing in
• Assembling instruements,counting before surgery
• Assist surgeon by passing over instruements
• Observe patient’s safety
• End of procedure
6. WELCOMING A PATIENT TO OR
• Welcome patient
• Introduce yourself
• Get personal information
from patient
• Ask if he/she needs any
further help
• Show her around (where
to sit,bathroom,changing
room etc)
• Ask to remove jewelry
7. Preoperative nursing assessment
• Age
• Allergies
• Presence of infections (temp ≥38)
• Vital signs
• Drugs contraindicated
(aspirin,heparin,warfarin)
• Nutritional status
• Physiological state(labs,x-rays)
• Psychological state
• Tolerance to anesthesia
(smoking,alcoholism)
9. “Scrubbing in”
• usually involves thoroughly
washing hands and arms with
an antibacterial soap, then
putting on a sterile mask, hat,
gown and gloves so that
patients cannot be
contaminated when their bodies
are exposed for surgery.
10. • Open the inner sterile set &
assemble sterile instruments
on mayo tray & trolley
• Perform surgical count
• Assemble surgical blade
• Prepare sutures
11. • Assist surgeon in cleaning & draping patient
• Bring mayo’s tray over the patient
12. • Pass instruments to
surgeon in a proper
position & safe
manner
• Pass & Receive
scalpel in kidney dish
• Place the skin knife
away from working
field
13. • Retract tissue gently if
required
• Remove artery tips as
directed by surgeon
• Cut sutures with
scissors,help in suturing
• Assist in cautery
14. • Anticipate surgeon
need through out
procedure
• keep one step
ahead of surgeon in
passing
instruments,sutures
,sponges etc
• Maintain neat &
orderly sterile field
of operation
15. • Maintain strict aseptic techniques
• Keep talking to minimum,turn away while
sneezing,coughing
Keep your hands at table level while unengaged
16. • Perform second surgical count of
sponges,sharps,instruements as surgeon begins closing
• Apply dressing to the wound by non touch technique &
assist in removing the drapes
17. • Dispose of sharps
• Cover the soiled
instruments before
sending them for
cleaning/autoclave
• Remove gown &
glove and check
documentation
18. SURGICAL NEEDLES
• Surgical needles
are necessary for
the placement of
sutures in tissues
• NEEDLE
ANATOMY
– Swage
– Body
– Point
20. Body of the needle
• classification by the body of the needle:
¼ circle 3/8 circle ½ circle 5/8 circle
Straight Half Curved (Ski) compound Curved
21. Point of the needle
- Conventional cutting
(cutting on the inside)
- Reverse Cutting
(cutting on outside)
- Taper point
(Pierce and spread tissue without cutting it
- Blunt
Pierce and spread tissue without cutting it.
22. The word "suture" describes any strand of
material used to ligate (tie) blood vessels or
approximate (sew) tissues.
Absorbable / Nonabsorbable
Natural / Synthetic
Braided / Monofilament
23. Example Suture Selection
Absorbable
Natural
Synthetic
Non Absorbable
Natural
Synthetic
Fast Absorbing Gut
Chromic gut
Plain Gut
VICRYLRapide*
(polyglactin 910) suture
VICRYL*
( polyglacin 910) suture
MONOCRYL*
(polyglecaprone 25) suture
PDS II*
(polydioxanone) suture
Stainless steel
Silk
Ethilon*
(nylon)suture
NOROLON*
(nylon)suture
MERSILENE*
(polyester) suture
ETHIBOND*
(polyester) suture
PROLENE*
(polypropylene)suture
24. Example Suture Selection
Absorbable (Natural)
Fast Absorbing Gut Plain Gut Chromic Gut
Tensile strangth 7 days
Mass absorption 21- 42 days
Tensile strength 7-10 days
Mass absorption 60-90 days
Tensile strength
Mass absorption
28 days
90 days
25. Example suture selection
Absorbable (Synthetic)
PDS II
VICRYL Rapide
Mass absorption 42 days
MONOCRYL
VICRYL
Mass absorption 56-70 days
Mass absorption 6 months
29. Artery Forceps
used as a hemostat for
clamping bleeding vessels.
For grasping tissue ( Opening and closing
peritoneum) .
to hold stay sutures.
Allis' Forceps
for grasping tough structures like Rectus sheath
or fascia in LSCS or Hysterectomy
Babcock's Forceps
for grasping tubular structures like
fallopian tube in tubectomy In
Pomeroy's operation , ureter,
appendix etc.
30. Self retaining speculum.
Used in OPD for routine examination.
procedures like taking of Pap smear ,
insertion and removal of Copper T can be
done
Sims' Speculum
for inspection of vagina and cervix in OPD. It
retracts posterior vaginal wall.
Taking Pap Smear , Insertion and removal of
Copper T, Taking swabs,D&C , Cervix Biopsy ,
Vaginal Hysterectomy ,
CUSCO’S SPECULUM
32. Mayo scissors
Straight mayo scissors
Curved mayo scissors
Towel clip
PINNARD’S FETOSCOPE
For auscultation of fetal heart sounds
33. Sims' Anterior Vaginal Wall
Retractor
To take biopsy from the cervix
Sponge holding forceps
Punch biopsy forceps
To hold sponges or cervical lips
Episiotomy Scissors
34. Toothed
To hold tough
structures like
rectus sheath,
vaginal flaps or
skin margins
during suturing
Non toothed
DISSECTING FORCEPS (TOOTHED AND
NON- TOOTHED
LOOP HOOK
To remove IUCD from the uterine cavity
when the threads are missing
ELECTRO CAUTERY
Thermal cauterisation of the cervix
for cervical ectopy
35. Foleys Catheter
•self retaining catheter used for drainage of the urinary bladder ,
It has a bulb below the tip.
•This can be inflated by normal saline. It has two channels. One for
inflating bulb and the other for drainage of urine to which urobag
is attached. No 14 or 16 are used in adult
Female metal catheter
•To empty the bladder prior to major vaginal operations
36. Hegar's Dilator
It is used for measuring length of the cervix
Uterine sound
For dilatation of cervix
TENACULUM
For grasping the cervix in hysterosalpingography or IUCD
insertion
37. Suction Curette
This instrument is used for first trimester MTP,
suction of vesicular mole.
Shirodkars Cerclage Needle
This is specially designed needle for putting
stitch around the cervix.
Khocker’s forceps
•used in hysterectomy /salpingectomy to
clamp fallopian tube
•for clamping umbilical cord of new born or
for artificial low rupture of membranes ( ARM).
40. Uterine dressing forceps
•To swab the uterine cavity following D+E
operation with a small gauze piece
UTERINE HOLDING FORCEPS
To fix and steady uterus when conservative
surgery is done on the adnexae
•To fix the myoma
•To give traction in a big uterus
requiring hysterectomy
MYOMA SCREW
41. MULTIPLE TOOTHED VULSELLUM
•used for grasping the cervix ( Usually
anterior lip of the cervix is grasped)
•in procedures like Insertion of IUCD ,
Cx Biopsy D&C, First trimester MTP
with Suction Evacuation. Cx Biopsy
•Posterior lip of the cervix is grasped for
post. colpotomy
SINGLE TOOTHED VULSELLUM
To hold the cervix after opening the vault of
vagina
•To hold new cervical stump after amputation
of the cervix and fothrergill’s operation after
subtotal hysterectomy
42. WRIGLEY'S FORCEPS
Obstetric forceps for out let
forceps delivery. Parts of
the forceps are blades (
which has windows or
fenestrate for firm grip of
the head) ,Shank , Lock(
English lock for Wriglys
forceps) , Handle.
VACCUM (VENTOUSE)
Alternative to forceps
delivery. Causes less
trauma to mother and
fetus
Silastic cup Metallic cup
43. Ayre's Spatula
Used for taking PAP smear
RING PESSARY
Used for correction of UV prolapse
UMBILICAL CORD CLAMP
UMBILICAL CORD CUTTING SCISSORS
