Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Organizing the District Hospital Surgical Service
Organizational and management of the district surgical service
The District Hospital
Leadership, team skills and management
Ethics
Education
Record Keeping
Evaluation
Disaster and trauma planning
The surgical domain: creating the envioronment for surgery
Infection control and asepsis
Equipment
Operating room
Cleaning, sterilization and disinfection
Waste disposal
Operating Room
 



> SPONGE AND INSTRUMENT COUNTS
> SCRUBBING AND GOWNING
> SKIN PREPARATION
> DRAPING





The operating theatre is a room specifically for use by the anaesthesia and surgical teams and must not be used for other purposes. A treatment room has equipment similar to an operating theatre, but on a smaller scale. Both rooms require:

:: Good lighting and ventilation
:: Dedicated equipment for procedures
:: Equipment to monitor patients, as required for the procedure
:: Drugs and other consumables, such as sutures, for routine and emergency use.

Ensure that procedures are established for the correct use of the operating room and that all staff are trained to follow them

:: Keep all doors to the operating room closed, except as needed for the passage of equipment, personnel and the patient
:: Store some sutures and extra instruments in the operating room to decrease the need for people to enter and leave the operating room during a case
:: Keep to a minimum the number of people allowed to enter the operating room, especially after an operation has started
:: Keep the operating room uncluttered and easy to clean
  Between cases, clean and disinfect the table and instrument surfaces
  At the end of each day, clean the operating room: start at the top and continue to the floor, including all furniture, overhead equipment and lights; use a liquid disinfectant at a dilution recommended by the manufacturer
  Sterilize all surgical instruments and supplies after use and store them protected and ready for the next use
  Leave the operating room ready for use in case of an emergency.


SPONGE AND INSTRUMENT COUNTS

It is essential to keep track of the materials being used in the operating room and during any complicated procedure in order to avoid inadvertent disposal or the potentially disastrous loss of sponges and instruments in the wound.

It is standard practice to count supplies (instruments, needles and sponges):

:: Before beginning a case
:: Before final closure
:: On completing the procedure.

The aim is to ensure that materials are not left behind or lost. Pay special attention to small items and sponges.

Create and make copies of a standard list of equipment for use as a checklist to check equipment as it is set up for the case and then as counts are completed during the case. Include space for suture material and other consumables added during the case.

When trays are created with the instruments for a specific case, such as a Caesarean section, also make a checklist of the instruments included in that tray for future reference.

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> SPONGE AND INSTRUMENT COUNTS
> SCRUBBING AND GOWNING
> SKIN PREPARATION
> DRAPING