Module 2_Basic Scrub

Question 1

How do you go about preparing yourself for the surgery?

Answer 1

1. Remove all watches, jewellery and ensure skin is intact, cover any wounds with water proof dressing
2. Apply surgical cap
3. Apply mask with surgical shield
4. Moisten fingers and clean nails out with nail pick and brush (first scrub of day only)
5. Moisten hands and arms with water placing sponge in one hand
6. Build a lather on palm of hand focussing on between the fingers, palm of hand, dorsum of hand and bring latehr down the arms towards elbow in twisting motion
7. Repeat step 6 for other hand
8. Rinse off lather by placing under running water and rinse off fingertips towards elbow
9. Repeat step 6-8 but only go halfway down arm
10. Repeat steps 6-8 but only go to wrist
11. Shake to get drips off, scout DA will turn tap off
    * Ensure hands and wrist do not touch sink, else start again

Question 2

How do you get the surgical gown on?

Answer 2

1. Scout DA unpacks gown and wipes touching only cloth that covers it
2. Operator/scrub DA wipes hands with towels via pat dry, concentrate on fingers, palms and dorsum of hand (one for each hand, do not bring towel back towards hands after patting elbow)
3. Grab gown as a complete bundle by grabbing neck/shoulder area
4. Let the gown unfold and place arms inside the gown and leave hands within the cuff gown at all times
5. Scout DA will secure the back of the gown with adhesive tape and tie, during this time keep hands only between waist and neck
6. Scout DA opens surgical gloves. You take them and leave them on sterile field from gown package. Don them by placing them on top of your hand and slide them on
7. Secure the front tie of the gown: give scout DA the cardboard at the end of the tie for them to hold. Turn around to pass the tie around yourself. Scout DA then pulls off cardboard and you secure the tie yourself at the front

Question 3

What position should the hands be placed in while idle and scrubbed?

Answer 3

-Prayer position (hold them together in front of you in about the chest area)

Question 4

How should the patient and bracket tray be prepared?

Answer 4

• Scout DA greets pt, confirms details, explains what will happen, confirms procedure, introduces everyone else
  2. Scout DA gives patient protective head wear and glasses and repositions chair
  3. Scout DA unpacks tray, confirms it has been sterilised and records the tracking number
  4. Scout DA opens surgical pack, and scrub DA opens it. Inside is patient drapes and disposables
  5. Scrub DA attach head drape ensuring it is sticking to the cap and not to patient’s skin
  6. Scrub DA covers patient’s body with body drape up to the knees. It is then secured to head drape with adhesive tabs

Question 5

How is the suction and handpiece assembled?

Answer 5

0. Get patient to put arms on abdomen to create a cradle where instruments can be held
1. Scrub DA hands scout DA end of suction which scout DA attaches to cannister. It is then clipped onto patient’s drapes so tube doens’t fall
2. Scout DA opens bagg for cassette for handpiece and scrub DA places on surgical tray.
3. Scrub DA connects handpiece to motor and scout DA connects other end to surgical unit. Handpiece then clipped to drape
4. Scout DA opens bur bag. Scrub DA grabs bur and inserts into handpiece. Handpiece placed across patient horizontally (do not place pointing towards patient’s face)
5. Scout DA opens irrigation tubing bag. Scrub DA attaches one end to handpiece. Scout DA attaches other end to surgical unit
6. Motor is tested to ensure functionality

Question 6

How should the rest of the tray be prepared?

Answer 6

1. Scrub DA Add irrigation to disposal surgical bowl and syringe 20mL out
2. Scrub DA Put in size 15 scalpel blade with needle holder (artery forceps). Grip it and slide on.
3. Light handle attached by scrub DA. Light turned on by scout DA

Question 7

What happens post-op in terms of cleaning/packing up?

Answer 7

• Operator (or scrub DA under direction from operator) starts by removing sharps
  1. Cut surgical suture near head of needle and place in sharps container immediately
  2. Scalpel blade removed and placed into sharps container
  3. Scout DA undoes gown from the back
  4. Scrub DA undoes the front, grabs gown from soild side only and slide off along with gloves in one motion
  5. Dispose of glove in waste bin
  6. Remove mask and hat