Operating Room

Sterile Field Before surgery is performed surgical drapes should be put in place to establish an aseptic barrier minimizing the passage of microorganisms from nonsterile to sterile areas. Only Sterile items should be in the sterile field. Sterile to Sterile ideas should be in place Open any sterile packages away from body to the sides and than towards your body Make sure sterile area does not become wet if so then you must set up a new field Never reach over sterile field Never turn back on sterile field General and Local Anesthesia:

General: Blocks all body sensations and cause unconsciousness, relaxation and loss of reflexes. Local, Regional, conduction blocks, or spinal anesthetics disrupt sensation to specific body areas or parts, without causing unconsciousness.

States of General Anesthesia:

Stage I: The beginning anesthesia when reflexes present, heart rate normal, slower rate and increased depth of respiration, normal blood pressure (BP), some dilation of eyes with reaction to light.

Stage II: Dreams and excitement, active reflexes, increased heart rate, irregular breathing, increased BP, pupils widely dilated and divergent.

Stage III: Surgical Anesthesia: Four planes, ranging from light to deep, with third and forth plane usually best for most types of surgery. Progressive loss of reflexes, decreased heart rate, progressively depressed respirations until apneic, normal to decreased BP, constricted to slightly dilated and centrally fixed pupils.

Stage IV: Danger Stage, Too much anesthesia has been administered, no reflexes, weak and thready pulse, respiration completely flaccid, decreased BP, widely dilated pupils. Prompt venation is required to prevent irreversible coma and death.

Commonly used preoperative medications and why given? Sedative is usually order the night before so the patient can sleep. Antibiotics before surgery to help prevent postoperative infections. A preoperative narcotic is given to relax the client and to enhance the anesthesia’s effects. Drying agent is given to help inhibit body secretions so the client produces less mucus. Circulation and Scrub Nurses: Circulation Nurse: Nurses with a four year degree and special training to keep the sterility of the operating room. Scrub Nurse:

One of the first duties of a scrub nurse is to work with the rest of the team to make sure that everything needed for the surgical procedure is in the room and that a sterile environment has been established. The scrub nurse becomes a surgeon’s go-to person when surgery begins. Observations for the patient once they get to recovery room: Check the patient’s condition continuously Vital Signs Pain Level Surgery Site Report any changes to the physician and anesthesiologists Complications that can occur in immediate post op period? Hemorrhage Shock Hypoxia: Interfere with blood oxygenation.

Hypoxemia: leads to lack of oxygen to tissues Hypothermia Foley Insertion Put patient in correct position and drape or cover Wash Hands Cleanse perineal area Wash hands put on sterile gloves Set up sterile field Drape Patient genitals if needed Test balloon Lubricate Foley tubing where insertion will take place Cleanse around Urethra Insert Foley Make sure you see urine flow Fill up balloon Secure in place to patients thigh and non removable part of bed. Document, Time, Size of Foley, What was seen coming out, How patient tolerated and the amount expelled right after insertion.

Put patient in comfortable position and cover To remove Foley make sure all urine has been emptied, deflate balloon instruct patient that they will feel pressure and to bear down has if having to urinate pull out Foley quickly and in one continuously until completely out. Put patient in comfortable position and document. 9. IVAD Removal: versatile intracorporeal ventricular assist device: should be removed in operating room under general anesthesia just like it is placed. Pre Surgical Experience:

Base Vitals signs are taken with a compete health history and any allergies are documented. The physician then goes over a release to complete surgery with the possible risks associated with said procedure and the expected recovery time. An Intravenous line is started with a average 23 gauge sized needle where the patients are given Versed and Fentanyl to relax and have memory of the surgery. Their vital signs are monitored and the average time for the procedure was 10 minutes. My observation in the Or consisted of ten pain management procedures preformed by an anesthesiologist.

This physician used an epidural block in the epidural space, Facet Joint Medial Nerve Branch Block, and a selective block which are done to the nerves in the neck through sacrum area the back. Patients are positioned on their side for neck injections and in a prone position for back injections. A Sterile Tray is then set up and all material the Physician will need at the time of procedure including medications for injections that will take place. A X-ray machine is placed over patient to help guide physician to place the needle in the correct nerve in the back or neck.

A durabond dressing is put in place to cover puncture marks from injections. This procedure is for trauma, arthritis or chronic pain to the neck through sacrum area of the back patients will feel relief from hours to weeks after procedure.

Recovery Rooms: Patients are taken to a recovery room where they much stay for at least 20 minutes where vitals must remain stable and patient is able to get a small snack and fluids down. Patients are discharged with orders for rest for the day and return to light activity for the next few days.

Read more: Circulating Nurse Duties | eHow. com http://www. ehow. com/list_7637647_circulating-nurse-duties. html#ixzz1iXhEv4d7

Read more: Circulating Nurse Duties | eHow. com http://www. ehow. com/list_7637647_circulating-nurse-duties. html#ixzz1iXhEv4d7.

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