(n) Dressings removed from a wound should be placed at once in a
bag, and the bag should be closed and discarded. Drainage that is left exposed to the
air may become dried, thus enabling the infectious organisms in it to become airborne
and carried to other parts of the surgical suite and the hospital to infect others.
(o) The circulator (and other team members performing nonsterile
duties) should wash their hands before and after the care of each patient.
Section V. ORIENTATION TO AN INDIVIDUAL OPERATING ROOM
In addition to knowledge of the equipment used in an OR, the OR
specialist must also be familiar with the arrangement of furniture and equipment for
various kinds of operations, since one of his duties will be the preparation of the room
for an operative procedure. Several factors are taken into consideration in determining
the arrangement of the furniture for a particular operation. Although the OR specialist
may not be required to make the decision as to the overall arrangement of the furniture,
he must keep in mind the relationship between "sterile" and "unsterile" team members
(refer to paragraphs 1-23i and 1-23j). The furniture should be grouped to facilitate the
maintenance of aseptic technique. Furniture that will be draped for use by the "sterile"
team members should be grouped together and adequate space should be allowed
between this furniture and the equipment to be used by "unsterile" team members to
promote sterile conditions.
1-25. PHYSICAL ARRANGEMENT OF ITEMS
a. Discussion. The furniture and equipment already discussed is common to
all cases and is kept within each OR. However, the type of operative procedure
and the method of administering anesthesia are the primary factors in determining
the supplies and equipment that are required as well as their arrangement. Some
of the equipment (normally kept in each OR but not scheduled for use
on a particular case) may be pushed to the wall in one area where it will not interfere
with the team member's work during the case. Equipment used infrequently may be
brought to an OR for a particular case and then returned to its storage area when
the case is finished.
b. Grouping of Equipment. The arrangement of the operating table and the
supply tables is determined not only by the type of case, but also by the location of the
operative area and the number supplies necessary. The furniture may be grouped with
the patient's head toward the door or toward any other part of the room.
Figures 1-30 A, B, C, and D show suggested grouping of items for general surgery,
perineal surgery, orthopedic surgery, and neurosurgery. In the figures, note the
placement of sterile instrument tables with relation to the area for the anesthetist
(anesthetist's stool). All sterile equipment and the "sterile" team members are as far
away from the "unsterile" anesthesiologist and his equipment as feasible to help
promote the maintenance of aseptic technique.