Setting Up the OR Jeff Lee MSIII

The Operating Room Where surgical operations occur Place of sterility Place of team work Prepare for many hours of standing Prepare to be pimped! Prepare to assist!

Before the Surgery (Pre- Op) Know which surgeries your attending is doing o Look at the big surgery board on 6 th floor before you leave OR visit scheduling office Read on the surgery you are going to be in on Prepare for questions KNOW YOUR ANATOMY!! o Regarding the area you are working on Know WHY your patient is being operated on

The Pre-Op area

Pre-Op Meet your patient! o Introduce yourself as the med student o Ask if you can be in their surgery o Let them know you are NOT the one operating o Ask them how they feel, if they need anything,etc Help roll or follow the anesthesiology team when they roll in your patient to the ER

In the OR Key players o Surgery team Attending- the boss Resident- the mini-boss You o Nurses Scrub nurse- nurse scrubbed in Assistant nurse- nurse that helps out, is not scrubbed in o Anesthesiology team Anesthesiology assistant/Anesthesist Anesthesiology attending (sometimes)

Anesthesiology Work- space

In the OR Once your patient is rolled in o Put on purple gloves o Introduce yourself to the nurses and ask if they need help Assist in o Making sure bed is level with OR table o Lock bed o Help assistant patient movement over to OR table o Help set up patient for OR Belt, compression socks, arm rests, shave hair off, etc

OR Beds

In the OR Depending on the Attending, they may be very specific to how they want their patient oriented, depending on the type of surgery Be prepared to help move the patient in different ways to appease such attending Once this is done, you may begin prepping for your scrub in

Prepping for scrub in Let the scrub nurse know you are scrubbing in, ask if she needs an extra gown on the table Let the assistant nurse know you are scrubbing in if she is the type to record names down Get your gloves o Double glove: wear one size smaller on top of your normal size. Ex. I wear at 7.5 underneath a pair of 7.0s Get your gown

Get your gloves and gowns here

Rule for scrub in prep DON’T TOUCH THE BLUE TABLE, THE TOOLS, ANYTHING WITH OR ON A BLUE STERILE FIELD

Prepping for scrub in When you open up a pack of gloves for the scrub nurse, open the sides and let the whole paper covering of the gloves stick out for her to grab; don’t take them out yourself! Same with a gown REMEMBER! DON’T TOUCH STERILE BLUE. SERIOUSLY, IT’S THE EASIEST WAY TO GET EVERYONE TO HATE YOU AND GET KICKED OUT!!

How to open your gloves

Scrub In Once the attending decides things are okay to proceed, go ahead and scrub in For more information on this, check out the “How to scrub in” portion!

During the Operation Resident and attending will place the sterile blue coverings on the patient Stand where they tell you to stand Don’t touch anything unless told Don’t take anything from the scrub nurse unless told Put your hands on the patient somewhere and don’t take them off unless doing something

Keep your hands on the patient!

After the operation What to do: o Help take blue covering off the patient & discard it o Take off your scrubs and gloves, discard them o Put on purple gloves o Help bring their bed back into the room o Wait for anesthesiology to wake up the patient o Help transfer patient to their bed After the black belt comes off, stand by the patient’s side as to not let them fall off There is a roll boarding procedure for moving patients from one bed to another; learn it! o Get warm blankets for the patient!

Roll Out! Help roll the patient to Post-Op Congrats! You now know what to do before, during, and after an operation!