The circulator is considered the "unsterile" member of the surgical team.
(1) An "unsterile" team member should never crowd past a "sterile" team
member or field. Allow sufficient space between you and the sterile field or between
you and gowned individuals when passing them.
(a) "Unsterile" team members should keep away from sterile areas.
"Unsterile" persons should allow a wide margin of safety when passing sterile areas.
(b) "Unsterile" persons should face a sterile area when passing it to
be sure you have not touched it.
(c) In addition, "unsterile" persons should not go within the sterile
"circle" or between two sterile fields.
(d) When passing behind a gowned team member, always notify him
to avoid possible contamination of his sterile attire if he should turn or move back and
(2) The circulator stands at a safe distance from the sterile field when
adjusting the light over it.
(a) Never reach across a sterile field. Stand outside the sterile field
and hold the extra supplies needed; allow the scrub to reach for them. Do not enter the
sterile field to perform any duties.
(b) When moving a sterile table, grasp the table legs well below the
tabletop and underneath the sterile drapes.
(c) The circulator "flips" the sterile suture material onto back table
(see Figure 1-4).
h. The edge of a cover that encloses sterile contents is not considered sterile.
Such covers include the edges of wrappers on sterile packages, the caps on solution
bottles, and test tube covers. No definite line separates the sterile from the unsterile
area at the edge of the cover; therefore, the edge is considered unsterile.
(1) The scrub should lift contents from packages by reaching for them with
the arm straight out and lifting the items straight up -- with the elbow held high
throughout the procedure.
(2) The circulator lifts the cap from a solution bottle so that the edge of the
cap never touches the lip. Caps are not replaced. The entire contents are dispensed
and any excess solution is discarded.