(3) The OR specialist should read the instructions, usually on a plate on the
machine or the instruction booklet appropriate to the machine.
(a) The circulator sets up the unsterile parts of the machine since he is
the unsterile member of the team. He must set the controls according to the surgeon's
orders. The circulator also places the foot pedal conveniently for the surgeon's use.
(b) The scrub sets up the sterile parts and checks the tip to ensure that
all parts are present; he inserts the tip into the handle. The scrub hands the end of the
cord with the plug to the circulator, who plugs it into the machine.
The unit is tested for proper functioning before the operative
c. Cardiac Arrest Tray.
(1) A sterile cardiac arrest tray is kept in a place easily accessible to the
ORs so that it is quickly available should a patient's heart stop beating
during the induction of anesthesia or the course of surgery.
(NOTE: The incidence of cardiac arrest is about 1 in 800 general anesthesia.)
The tray contains the instruments necessary for opening the patient's chest and
retracting his ribs, thus enabling the surgeon to use his hand to pump the patient's
heart. Cardiac arrest is a dire surgical emergency because when the heart stops there
is no circulation of blood and therefore no oxygen is available to the tissues. The
tissues of the brain are very quickly damaged by anoxia: thus, the time limit for
institution of corrective treatment is considered to be from three to five minutes.
(2) In view of the above considerations, Army hospitals require that a
preparedness program be in effect. Cardiac arrest trays are therefore located in all
areas where anesthesia (either local or general) is administered. All personnel working
in such areas must know where the trays are located.
Section IV. ASEPTIC TECHNIQUE/INFECTION CONTROL
a. Discussion. The term asepsis means the absence of any infectious agents.
All things that come into contact with a wound should be free from all microorganisms
(sterile) or as free as possible for the protection of the patient. In order for the
OR specialist to understand the reason for doing many procedures in a
way, he needs to know the principles of aseptic technique. These principles
serve as a guiding factor in the performance of all tasks in a surgical suite, including the
routine cleaning or housekeeping procedures.