f. Aseptic Technique. Each person on the surgical team must take the utmost
care to carry out strict asepsis. Dust control, proper cleaning of floors and furniture, and
sterilization of instruments and equipment are essential, along with scrub, mask,
glove, and gown technique. Any break in asepsis at any point nullifies all the care taken
in other ways.
g. Drugs. The same strict rules observed on the ward in regard to drugs must
be practiced in the OR. The scrub frequently has dangerous drugs such as phenol
or cocaine on his table. Special care must be taken to ensure that these are not
used improperly. Each drug used is checked by two persons as it is prepared, and the
scrub repeats the name of the drug to the surgeon as it is handed to him.
h. Abandonment. A patient left alone or a child unguarded may injure himself
by an electric shock, burns, drugs, lacerations, falls, or a variety of other things. The
sources of such injuries should be removed whenever possible and a patient who might
injure himself carefully watched.
i. Explosions. Great care must be taken in the OR to prevent
explosions.
j. Tissue Specimens. The loss of a biopsy specimen could mean the
possibility of a second surgical procedure to obtain another. Improperly labeled
specimens could mean a mistaken diagnosis, with possible critical involvement for two
patients. The loss of a specimen could be vital if diagnosis is not made and proper
treatment not given. A report from pathology on a specimen is a permanent record on
the patient's chart that a certain piece of tissue or a stone has been removed.
k. Foreign Bodies. Care for these according to local policy. They often have
legal significance outside the hospital, and frequently are claimed by civilian or military
police. A receipt should be required of anyone taking them.
l. Consent for Operation. As a rule, witnessed written consent for an
operation or procedure is signed by the patient before the surgery or procedure is
performed. The patient must understand the details of the agreement fully. If the
patient is a minor, unconscious, incompetent, or intoxicated, the nearest of kin or some
other authorized person must sign. If a true emergency exists and no one else is
available to sign the consent, the Judge Advocate's Office should be contacted. When
this is not possible, the hospital administration may give permission for the procedure or
surgery.
MD0923
2-27