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How to observe In Surgery
1. By : Kareem Hamimy
6th year Medical Student
Kasr Al Ainy Faculty of Medicine
Cairo University
2. This ppt is designed to give a simple tips for
Surgery Interns, observers, Medical students
About observation in OR ( Operation Room )
3. I would like to thank everyone who gave me
he opportunity to attend and assist in
Surgical operations in Kasr Al Aini
(Professors, Lecturers, Residents, Nurses,
Workers, patients )
4.
5. 1st : Check The Surgery unit that you are going
to attend with.
2nd : Introduce yourself to the Resident, and ask
him for the permission to attend.
3rd : Know the schedule of unit .
( when is the grand round, when are the operations ? )
4th : The day before operation, get the List of
patients who are going to OR ).
5th : Try to take a brief History and full
Examination to these patients.
6. 6th : Try to read about this Disease,
Management, Operative technique, the Night
before the Operations, for Maximum benefit
7.
8.
9. In Kasr Al Ainy, Scrubs
are not provided in OR
So Don't forget to pack
your bag with your
clean ironed scrubs.
10. Before Exiting
lockers you have to
check that you
didn’t miss wearing
any of these :
Scrubs
Overshoes or /
Surgical Clogs
Overhead
Mask
11.
12. In The OR, You have to be
Away from Aseptic Field 50 cm
Away from the operation table
Away from The Surgical instruments table
Away from scrubbed surgeons
Away from Anesthesia field
Away from troubles
Don't ask a surgeon when he is nervous, or when
there is complete silence as this is an indicator of a
precise part of operations which needs ultimate
concentration
13. While observing, you have to be sure that you
know
Diagnosis
Decision ( & why )
and try to correlate what you read before
with what you are observing
15. Type ( Spinal, Regional, Epidural, General)
Technique
Intubation ( how ? )
Cannulation ( IV cannula, Central line )
Medications used, Dosage
Monitor
16. Position of the Patient ( Supine, Prone, Hand
Extended, Elevated, Lithotomy )
Exposure
Antiseptic application
Borders, one way strokes
Surgical Sheets ( how they are applied ? )
Light ( Direction ? )
17.
18. Incision
Extensions
When to extend it ? ( Observe when is this
decision taken )
Layers ( what are the layers incised ? )
19.
20. Traction and Counter Traction
Surgical Instruements used
And why this specific instruement not the other ?
21.
22. Important Structures ( Anatomy ? )
Dangerous Areas
23.
24.
25. Drainage
Why
Type ( Suction, …)
Size
Position
How ?
28. How? ( Simple, Subcuticular ), and ask the
resident to show you how is it done
Material ( proline, Vicryl, silk )
When? ( ask when to use different types, and
size ? )
And why ?
30. Waking the patient ( anaesthesia )
Postoperative care
Visiting patient, the next day of operation is
essential, try to follow to observe Recovery
phase, and if complications occurred, and
how to manage
31. After being Familiar, with the OR, and the
operations,
You can ask the resident, to scrub in for
assistance and better observation
32. Prof Dr Aly Haseeb : Illustrated Operative
Surgery.
Browse Symptoms and Signs of Surgical
diseases.
Oxford Handbook of Clinical Surgery.
Basic Surgical Techniques ( R M Kirk ).
Essential General Surgical Operations ( R M
Kirk ).