(2) Other more detailed references may also be available. Some books
describe the operative procedure, the operative area, the site and kind of incision, the
position, and the draping. One that includes these descriptions (and is established as
an Army field manual) is Alexander's Care of Patient in Surgery. This book also lists
instruments and sutures necessary for operative procedures; however, these lists are
not always applicable to all hospital ORs. NOTE : Many terms pertaining to
an operation are abbreviated. As an example, in the listing, (see figure 2-3), of the
radical neck dissection. "STSG. DSRT. THIGH" indicates that the patient will have a
split thickness skin graft and his right thigh will be used as the donor site. If the
specialist assigned to scrub or circulate for an operation is uncertain of the meaning of
any abbreviation of the schedule, he should ask the NCOIC or an AN Officer. Operative
procedures performed on a bilateral structure should always indicate the side of the
procedure. T and A (see figure 2-3) stands for tonsillectomy and adenoidectomy.
C-section is the abbreviation for cesarean section.
h. Surgeons. (See figure 2-3). The name listed first denotes the surgeon in
charge of the operation. The names that follow are other MC Officers assigned in the
order of first assistant, second assistant, and so forth.
(1) The circulator. The number of surgeons listed indicates to the circulator
the number of gowns necessary. The circulator also finds out the glove sizes for the
MC Officers listed.
(2) The scrub. Before scrubbing up, the scrub obtains the surgeon's
preference card (see paragraph 2-32) for the surgeon in charge of the operation. He
follows the information on the card with regard to preparation of sutures and any special
equipment listed. The scrub also determines what his position at the table should be in
relation to this group--to the right or left of the surgeon and at which side of the
operating table. In making this decision, the scrub considers a number of factors,
including the following--the location of the operative area and any special needs
imposed due to either the location or the nature of the surgery; the working habits and
preference of the surgeon; the number of members of the sterile team and their tasks;
and whether or not any members of the sterile team are left-handed. The scrub then
sets up the Mayo stand, the back table, and the basin (ring) stand for his use in
accordance with his position at the OR table. Note the grouping of the sterile tables in
figure 1-30A, B, C, and D.
i. Nursing Staff. (See figure 2-3). The OR specialist and other OR
personnel assigned to work on the cases are listed in the column headed "Nursing
Staff." "Scrub" and "circulate" may be abbreviated "S" and "C." Duties of the scrub and
the circulator include those set forth in paragraph 2-18. Whenever two team members
are assigned to scrub, the first listed is the senior (or the more skilled) team member
and the other serves as the assistant.