Figure 3-22. Arrangement of instruments on the Mayo stand.
OPENING SMALL STERILE ITEMS
a. As you arrange instruments from the instrument set on the back table and
Mayo tray, you will open other small items and arrange them on both the back table and
Mayo tray in preparation for the operation. Some have been mentioned which were
displayed in the illustrations.
b. The emesis basin is placed on the back table. The sponges, the 4 x 8's, the
suction tubing, the stick sponges, etc., are wrapped separately and must be opened and
arranged. The circulator may open the wrappers and pass them to the scrub as shown
in Figure 3-23. The circulator will pass the knife blades to you and you will attach the
knife blades to the handles. You must always use an instrument (a strong needle
holder), never your fingers, to attach the blade to the handle. Holding the cutting edge
down and away from you, grasp the blade at its widest and strongest part with a needle
holder and slip the blade into the groove on the knife handle. When you hear a click,
you know the blade is in place. You must never touch the cutting edge of the blade.
After inserting the blades, place the knife holder with blade on the Mayo tray as shown
in Figure 3-22.
INITIAL SPONGE COUNT
a. Each type of operating room procedure requires different kinds and
numbers of sponges, needles, and instruments. Each of these items is a foreign object
that could cause unnecessary harm or death should it be left inside the patient. To
protect the patient, these items are counted before and after use. A counting procedure
is a method of accounting for items put on the sterile table for use during a surgical
procedure. The counting procedure may differ at various hospitals, but the count itself
is mandatory. This subcourse will focus on sponge counts.