j. Anesthetist. (See figure 2-3). If the patient is to be given local infiltration
anesthesia, the surgeon's name is repeated in this column, or the word "surgeon" may
be entered. For anesthesia administered by a member of the anesthesiology service,
the name of the anesthetist assigned for the operation (either MC or AN Officer) is
entered. The circulator should put a revolving stool in place for the anesthetist (see
paragraph 1-17a and figure 1-15). If the surgeon is scheduled to administer the
anesthetic agent, the circulator should see that a source of oxygen is available in the
room. (The gas anesthesia apparatus provides this source of oxygen unless piped-in
oxygen is available.)
k. Anesthetic. (See figure 2-3). The information entered in this column
indicates whether a local or a general anesthetic will be given, the method of
administration, and often the anesthetic agent to be used. The word "endo" (an
abbreviation for endotracheal) is usually added if the anesthetist is going to intubate the
patient (insert a tube which provides an artificial airway into the patient's trachea by way
of his nose or mouth). Additional time (15 or 20 minutes) is required for anesthetizing
when a patient is to be intubated.
(1) The listing of the type of anesthetic may be of assistance in the selection
of instruments. For example, an operation scheduled as "excision of keloid, right
forearm" gives no information about the size of the surgical wound. If it is scheduled for
local anesthesia rather than general, the specialist can safely assume that the incision
will be small, to be closed without skin grafting.
(2) The letter "T" followed by a number of ml (1000, 1500 ml, and so forth)
indicates that whole blood has been ordered from the laboratory and is available in the amount
listed, and the patient has been typed and cross matched in anticipation of his need for
a transfusion during the operative procedure.
l. Summary.
(1) Practice and experience will increase the student's knowledge greatly.
Both the scrub and the circulator can obtain much information from the references
available in the OR suite. These references include the procedure manual,
instrument card file, surgeon's reference cards, the various DA Forms (especially the
OR Schedule), standing operating procedures or policy file, and available
dictionaries.
(2) The references listed serve to give assistance and direction to all
members of the surgical team. The OR specialist enhances his value to other members
of the surgical team and provides more effective care of the patient when he is able to
interpret and apply the information available.
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