The Intra-Operative Phase and the Surgical Team
The intra-operative phase is the period during which the patient is undergoing surgery in the operating room. It ends when the patient is transferred to the post-anesthesia recovery room.
After completing this lesson, you should be able to:
Cite Classification of Surgical Procedures undertaken.
Understand reasons for Surgical Intervention.
Cite from descriptive statements, the key members of the surgical team.
REASONS FOR SURGICAL INTERVENTION
Descriptors used to classify surgical procedures include ablative, diagnostic, constructive, reconstructive, palliative, and transplant.
These descriptors are directly related to the reasons for surgical intervention:
• To cure an illness or disease by removing the diseased tissue or organs.
• To visualize internal structures during diagnosis.
• To obtain tissue for examination.
• To prevent disease or injury.
• To improve appearance.
• To repair or remove traumatized tissue and structures.
• To relieve symptoms or pain.
Key Members. The Intraoperative phase begins when the patient is received in the surgical area and lasts until the patient is transferred to the recovery area.
THE SURGICAL TEAM
Although the surgeon has the most important role in this phase, there are five key members of the surgical team are as follows;
The Scrub Nurse
The Circulating Nurse
Key Members. The intraoperative phase begins when the patient is received in the surgical area and lasts until the patient is transferred to the recovery area. Although the surgeon has the most important role in this phase, there are five key members of the surgical team.
The Surgeon. The surgeon is the leader of the surgical team. The surgeon is ultimately responsible for performing the surgery effectively and safely; however, he is dependent upon other members of the team for the patient's emotional well being and physiologic monitoring.
Anesthetist. An anesthesiologist is a physician trained in the administration of anesthetics. An anesthetist is a registered professional nurse trained to administer anesthetics. The responsibilities of the anesthesiologist or anesthetist include:
(1) Providing a smooth induction of the patient's anesthesia in order to prevent pain.
(2) Maintaining satisfactory degrees of relaxation of the patient for the duration of the surgical procedure.
(3) Continuous monitoring of the physiologic status of the patient for the duration of the surgical procedure.
(4) Continuous monitoring of the physiologic status of the patient to include oxygen exchange, systemic circulation, neurologic status, and vital signs.
(5) Advising the surgeon of impending complications and independently intervening as necessary.
Scrub Nurse/Assistant. The scrub nurse or scrub assistant is a nurse or surgical technician who prepares the surgical set-up, maintains surgical asepsis while draping and handling instruments, and assists the surgeon by passing instruments, sutures, and supplies. The scrub nurse must have extensive knowledge of all instruments and how they are used. The scrub nurse or assistant wears sterile gown, cap, mask, and gloves.
Circulating Nurse. The circulating nurse is a professional registered nurse who is liaison between scrubbed personnel and those outside of the operating room. The circulating nurse is free to respond to request from the surgeon, anesthesiologist or anesthetist, obtain supplies, deliver supplies to the sterile field, and carry out the nursing care plan. The circulating nurse does not scrub or wear sterile gloves or a sterile gown. Other responsibilities include:
(1) Initial assessment of the patient on admission to the operating room, helping monitoring the patient.
(2) Assisting the surgeon and scrub nurse to don sterile gowns and gloves.
(3) Anticipating the need for equipment, instruments, medications, and blood components, opening packages so that the scrub nurse can remove the sterile supplies, preparing labels, and arranging for transfer of specimens to the laboratory for analysis.
(4) Saving all used and discarded gauze sponges, and at the end of the operation, counting the number of sponges, instruments, and needles used during the operation to prevent the accidental loss of an item in the wound.