(5) Advising the surgeon of impending complications and independently
intervening as necessary.
d. 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. In the Army, the Operating Room Technician (MOS 91D) often
fills this role. The scrub nurse or assistant wears sterile gown, cap, mask, and gloves.
e. 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 onitoring the patient.
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.
MAJOR CLASSIFICATIONS OF ANESTHETIC AGENTS
a. There are three major classifications of anesthetic agents: general anesthetic,
regional anesthetic, and local anesthetic. A general anesthetic produces loss of
consciousness and thus affects the total person. When the patient is given drugs to
produce central nervous system depression, it is termed general anesthesia.
(1) There are three phases of general anesthesia: induction, maintenance,
and emergence. Induction, (rendering the patient unconscious) begins with administration
of the anesthetic agent and continues until the patient is ready for the incision.
Maintenance (surgical anesthesia) begins with the initial incision and continues until near
completion of the procedure. Emergence begins when the patient starts to come out from
under the effects of the anesthesia and usually ends when the patient leaves the operating
room. The advantage of general anesthesia is that it can be used for patients of any age
and for any surgical procedure, and leave the patient unaware of the physical trauma. The
disadvantage is that it carries major risks of circulatory and respiratory depression.