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OPERATING ROOM NURSING BY: Miss Shenell A. Delfin,RN
Surgical  Instruments are classified according to their use
Cutting Instruments ,[object Object],[object Object],[object Object],[object Object]
Blade #12
Scalpel Blades
#3 Scalpel Handle #4 Scalpel Handle
Knife
Scissors ,[object Object]
[object Object]
Mayo Scissors
Metzenbaum Scissors
[object Object]
Suture Scissors
[object Object]
[object Object]
Bandage Scissors
Tissue Forceps ,[object Object]
[object Object]
Thumb Forcep
Debakey Tissue Thumb Forceps
[object Object]
Tissue Forcep w/ Tooth
Grasping and Holding  Instruments ,[object Object]
[object Object]
Allis Forcep
[object Object],[object Object]
Babcock Clamp
[object Object],[object Object]
Ochsner Forceps
[object Object],[object Object]
Single Tooth Tenaculum
Uterine Tenaculum
Clamping Instruments Clamping and Occluding –  instruments that clamp and occlude are used to apply pressure
[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object]
Crushing Instruments / Crushing Clamps ,[object Object],[object Object],[object Object],[object Object]
Mosquito Forcep (curved)
Mosquito Forcep (straight)
Round Nose/Kelly Forcep (curved)
Round Nose/Kelly Forcep (straight)
Mixter Right Angle Forceps
Rochester Carmalt Forcep
Rochester Pean Forcep
Retracting Instruments ,[object Object],[object Object]
[object Object],[object Object]
Army-Navy Retractor Senn Retractor
Richardson Retractor
Sim’s Retractor
Vaginal Weight Retractor
[object Object],[object Object]
[object Object],[object Object]
Weitlaner Retractor
Balfour Retractor
Temple – Faye Retractor
Gelpi Retractor
Finochetto Retractor
Viewing Equipment ,[object Object]
Nasal Speculum
Vaginal Speculum (small)
Anal Speculum
As a Scrub Nurse   Performs surgical scrub using the accepted technique. Gowns and gloves himself using the proper technique. Opens sterile packs and set correctly Counts instruments and sponges correctly. Assist in draping the patient. Anticipates the need of the surgeon.
Keep sterile field neat, clean and dry. Counts instruments and sponges before the end of operation
Hands and serves instruments and sterile supplies adeptly
Prepares the dressing properly. Washes and keeps the instruments used.
Properly label specimen. Disposes waste material properly
Assist in cleaning, re-arranging and preparing the room for the next case.  Assist with drying and packing of instruments.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The circulating nurse is also responsible for correctly labeling and caring for the surgical specimen.  If a frozen section is to be performed, he/she would be responsible for contacting pathology.
If a sponge drops on the floor, the circulating nurse removes the sponge using an instrument or gloved hand and wipes the area immediately with a hospital grade disinfectant.
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Once the desired surgery is accomplished, the surgeon is ready to close the incision.  All instruments and sponges are removed from the wound.  The surgeon may wish to irrigate with warm saline at this time.  The circulating nurse will need to pour additional saline from the warmer.  The scrub nurse must test the temperature of the saline to make sure it is not too hot. 
Prior to suctioning the saline from the wound, the scrub nurse should note the amount of blood in the suction canister and anesthesia personnel should record this blood loss.
A sponge, needle, and instrument count is performed at the beginning of closure.  The first layer of closure is the peritoneum.  If the surgeon chooses to close this layer, he/she may grasp the peritoneum with three to four kelly or pean clamps to lift it and avoid injury to the underlying organs while suturing.  Suture for this layer may be 0 or 2-0 absorbable on a tapered needle using a long needle holder.  A continuous stitch would be used.  Pick up forceps would be long and smooth.
Personal Attributes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Manner of reporting (CEH) ,[object Object]
Sutures
 
 
 
 
 
 
Counting Procedures in OR ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object]

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