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Surg tools and equip

What are instruments made of? Stainless steel, high in carbon to harden and less likely to wear, and chromium which is more corrosive resistant
Three types of instrument finishes? Polish mirror finish- have more chromium, but alot of glare Stain or dull finish- more common in OR bc of less glare Ebonized (black chromium)- no reflective, used in laser cases
Name the parts of an instrument shank-Area b ratchets, finger rings
Jaws hold tissue securely, serrated, some have carbide insert that is replaceable, working end of instrument.
box lock joins the 2 halves of the instrument and allows the opening and closing. Maybe the a "screw joint"
Shank -Area between box lock and finger ring. -Gives instrument leverage -Should be balance on both ends -Length is appropriate to wound depth
Ratchets Keep instrument "locked shut: when the instrument is closed on tissue or object that is being grasped.
What ratchet do instruments need to be on when on the Mayo stand?? the 1st ratchet
Finger rings Provide for ease of holding and manipulating instrument
What are the 9 categories of instruments? 1. Cutting and Dissecting 2. Grasping 3. Clamping 4. Retracting 5. Probing 6. Dilating 7. Needle holders 8. Suction 9. Accessories
Mayo Scissors Cutting and dissecting, 2 types: curved, used for heavier tissue. Straight, or suture, used for delicate tissue cuts sutures and drapes
Metz scissors Cutting and dissecting, Used to delicate tissue
Jorgenson Cutting and dissecting used for hysterectomies and OBGYN surgeries
Potts Smith Cutting and dissecting'used on delicate procedures
what knife blades can be used on a #3 knife handle? #10,#11, #12, #15 (used for superficial procedures)
What is the most common blade for skin? #10
What knife blades will fit a #4 knife handle? Only a #20, used deeper in the body
Rongeurs Cutting and Dissecting, Cut and extract tissue, tips are cupped, very sharp, used for orthopedic and neurosurgery
Beaver blade used for ear and eye procedures
Forceps Grasping and holding, holds tissue in place, Ex. Adson and tissue forceps
Kocher Biting clamp, Grasping and holding used on hysterectomies
Tenaculum Grasping and holding, penetrates tissue like the cervix, holds tissue
Debakey Grasping and holding, tissue forceps that are used on delicate tissue inside the body
Babcock Clamping and occluding, Atraumatic clamp that is meant to surround or clasp. Used on bowel or Fallopian tube, non crushing
Hemostat Clamping and occluding, Occluding clamp that stops blood flow
Murphy rake retracting and viewing, 4 or 3 prong, can be sharp or dull(rounded)
Self retaining retractor retracting and viewing, better visualization, can be sharp or dull
Richardson Retracting and viewing
Probing Detects and obstruction or follows a hollow tract. used to enter a lumen that occurs naturally. Urethra or anus is a natural lumen
Dilating Widen or stretch the inside of lumen, allows for larger instruments to enter.Used to increase the diameter of a lumen, cervix in gyny surgery, Ex. Cervix, urethral, esophgeal
Suturing Needle-holder fine, regular or heavy. Grasp needle Place or remove blade on scalpel
Suctioning Removal of blood and fluids from surgical site
3 types of suctioning Yankauer-all purpose Frazier-primarily orthopedic, neurologic surgery Poole-Primarily abdominal and thoracic surgery
Suctioning Removal of blood and fluids from surgical site
3 types of suctioning Yankauer-all purpose Frazier-primarily orthopedic, neurologic surgery Poole-Primarily abdominal and thoracic surgery
What are two types of accessories Towel clips and ring forceps
How do you handle instruments? -handle gently -do Not throw them into basins -Protect cutting surfaces -Do NOT soak or rinse in saline -Keep them wiped off during a case -Use the correct instrument
What causes instruments have a reduced life? -Most damage is caused by improper cleaning and processing, and handling
Who does the "counts" before and after the procedure? Scrub or circulator
What to do when dismantling instruments. -Check drapes, towels, and table covers -Collect instruments from Mayo stand -Separate delicate, small instruments -Disassemble all instruments -Open all hinged instruments -Separate instruments of dissimilar metals
Dismantling cont.. -Flush cold distilled water through hollow instruments -Rinse off blood and debris
What to remember! Handle loose instruments seperately to prevent interlocking or crushing -Keep ring-handled instruments together -inspect/sort instruments -leave retractors and other heavy instruments in the tray -Protect sharp blades, edges and tips
Richardson Retractor -Specialty: General -Usually comes in pairs -Retracting/Exposing
Parker Retractor -Specialty: General -Retracting/Exposing
Army-Navy retractor -Specialty: GEN -Retracting/Exposing
Senn Rake Retractor -can be Sharpe/Dull -Specialty: General/Plastics -Retracting/Exposing
Vein retractor instrument ending in a rounded flange set transversely for engaging and retracting soft tissues.
Poole suction -Specialty: General/Thoracic -Suctioning -primarily abdominal region
Metz scissors (2 types) -Comes curved or straight. -Most often curved. -Also can come as Thyroid Metz (small), Regular Metz, and Extra long Metz. -Used to dissect delicate tissue. -Usually called "Metz" -Specialty: General -Cutting
Mayo scissors (2 types) -Curved are used for dissection. -Straight for cutting suture. -All specialties. -Cutting
Bandage or trauma scissors -Lister Bandage Scissors -General utility scissors used in -most specialties. -Cutting -Not used on tissue
Debakey Forceps -Used on delicate tissue. -Specialty: General -Grasping
Adson forceps w/ teeth -frequently used to close the skin when using suture or for everting skin edges for staple placement. -Specialty: General/Plastics -Grasping/Holding -Always hand to surgeon after suture
-Toothed Thumb Forcep -Specialty: General/GYN -Grasping/Holding - commonly held between the thumb and two or three fingers of one hand
Smooth Thumb Forceps -Specialty: General/GYN -Grasping/Holding
Crilewood Needle Holder -Specialty: Small Gen and Plastics -Suturing
Mayo Heager Needle Holder -All specialties -Suturing
Heaney Needle Holder -Specialty: GYN -Always load the needle with the curve of the needle holder pointing away from the tip of the needle. -Suturing
Forester Sponge Stick Also known as a ring forcep. -It doesn't become a sponge stick until the sponge is put on it. -Specialty: General/GYN
Kelly Clamp -Used in all specialties -Also known as a pean (pee-on) -Clamping/Occluding
Allis Clamp -Specialty: General -Grasping/Holding
Allis-Adair Clamp -Looks like an Allis but with a wider tip and more teeth. -Specialty: GYN -Grasping/Holding
Babcock Babcock Specialty: Gen/GYN -Autraumatic clamp most often used delicate tissue such as the bowel and fallopian tubes. -Grasping/Holding
Kocher clamp Kocher Clamp -Multiple specialties -Grasping/Holding/Clamping
Bachaus Towel Clip -Used for holding towel drapes in all specialties. -Grasping/Holding -Can be used to grasp bone,myomas or skin when placing the verres needle.
Russian Forceps -Specialty: GYN -Grasping/Holding
What is the Electrosurgical Unit? -Application of heat speeds up the natural chemical reaction of blood to stop clotting. -Electric current can be used to cut or coagulate most tissues.
Components of the ESU Generator, Active electrodes, and Inactive dispersive electrode
Generator -Machine that produces the power for the "active electrode" to coagulate or cut tissue.
Active electrode sterile handpiece that directs the flow of current to the operative site. -activated by surgeon -can have hand or foot switch
Inactive Disperive electrode -known as the "grounding pad" -disperses the current released through the active electrode and provides a return from the tissues back to the generator. -plugged into generator "Bovie machine" -never place on metal implants
Two types of ESU Monopolar and Bipolar Unit
Monopolar Unit The current flows from generator to active electrode, through the patient to an inactive dispersive electrode, and then back to the generator. -HAS "grounding pad"
Bipolar Unit Alows current to flow only b/w the tips of the active electrode and returns to the generator. -Does NOT have a "grounding pad"
Endoscopic Units -Used for diagnosis, biopsy, visualization or repair. -used through an existing body opening (urethra) -may be rigid(not flexible) or flexible (bendable)
Flexible Endoscope -Needs light and air source -has accessory items such as biopsy forceps, brushes, and polyp snares
Rigid scopes -Need "lap tower" needs light source, light cable, monitor, video recorder,insufflator, and instruments
Insufflator taking of a veress needle and putting it in the belly button and attach CO2 to inflates the belly and brings organs down
Operating microscopes -Used for microsurgery -Ex. neurosurgery and eye surgery -Has objective lens and Ocular lens
3 types of power surgical saws Rotary- Used to drill holes or insert screws, wires, or pins Reciprocating- a cutting action from front to back/back and forth Oscillating- a cutting action from side to side All three may be powered by battery, nitrogen, or compressed air
Pneumatic Tourniquet -Used on extremities to restrict blood flow -Everyone in the OR should be aware what time this is turned on -Used for a maximum of 1-1.5 hours -If on too long, could cause tissue or nerve damage
What is the purpose of drapes? -Isolate and protect the surgical site -Barrier against contaminates -Fluid, tear and flame retardant -Disposable or non-disposable
Types of drapes -Fenestrated- has opening, laparotomy -nonfenestrated- "square drape" split sheet or U-drape -extremities -Stockinette- rolls up and goes around legs, used for leg surgery, cut already in it,sticky -Incise- sticky & have antimicrobial, accordion like
Types of sponges lap sponges, radiopaque sponges 4x4's Kitners and peanuts, tonsil sponges, and cottnoids
Laparotomy sponges -Most absorbant -5 per package - If the count in a pack is off, the STSR must open a new pack and the old one must be discarded
Radiopaque 4x4's -Smaller, less absorbent -"Raytec sponges," shows up on x-rays -10 per pack
Kitners and Peanuts -Dissecting sponges Peanuts -rolled up sponges used for fluid absorption on the tip of an instrument -radiopaque -put into its own container when don using Kitner- small roll of cotton tape, not sticky
Tonsil sponges -Cotton filled with strings -used for tonsillectomy -5 per package
Cottonoids -10 per package -neurosurgical patties -protect delicate neural tissue -Radiopaque with string -need to be moistened with saline -used on brain and spinal procedures -saline prevents sticking
What is the purpose of dressings? -To prevent the wound from trauma/contamination -Absorb drainage -Support incision -Provide pressure -Conceal wound
Created by: junkman3120
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