Fundamentos de enfermería - instrumentación quirúrgica 04

Summary

This transcript covers a detailed guide to surgical positioning, aseptic techniques, and skin preparation during procedures. It explains various patient positions such as Fowler’s, Sims, lateral, and prone, along with the importance of proper body alignment and the risks involved. The script also describes the steps for preparing the skin with antiseptic solutions, ensuring a sterile field, and the correct placement of surgical drapes and instruments. Additionally, it emphasizes maintaining aseptic conditions, proper handling of materials, and post-procedure safety to avoid complications during surgeries.

Takeaways

• 😀 Proper positioning is essential for various surgical procedures, including facial, cranial, reconstructive, and thoracic surgeries. The patient’s head may need stabilization with a frame or gel rings in certain positions.
• 😀 Lateral and Sims positions are commonly used for renal and cardiothoracic surgeries, with attention given to which side is placed on the operating table.
• 😀 Prone positioning, where the upper body rests on a cushioned frame, requires extreme caution to avoid risks such as nerve damage or compromised ventilation.
• 😀 Skin preparation is done immediately before surgery, with the surgical site and surrounding area being cleaned and painted with an antiseptic solution to reduce bacteria.
• 😀 Only approved antiseptic agents should be used for skin preparation, including iodine, chlorhexidine gluconate, and alcohol, and these solutions should be handled in a sterile manner.
• 😀 The surgical field must be sterilized by using sterile gloves and equipment, ensuring that materials like gauze and cotton are only used for specific purposes, such as skin preparation or during surgery.
• 😀 Proper aseptic technique is crucial in ensuring the sterility of surgical fields, with special care taken when handling instruments and fields during the operation.
• 😀 Surgical fields are created using sterile drapes or covers to form a sterile barrier around the surgical site, which helps maintain cleanliness and avoids contamination during the procedure.
• 😀 The correct placement of surgical drapes, particularly fenestrated drapes, is necessary to establish an accessible and sterile surgical site, with specific protocols for the abdominal area.
• 😀 After surgery, all materials used in the sterile field, including gauze and instruments, must be accounted for and properly disposed of to ensure no items are left behind inside the patient.

Q & A

What is the Fowler position used for in surgical procedures?

The Fowler position is used for facial, cranial, reconstructive, and breast surgeries. The operating table is flexed to allow this position, and additional supports like a gel or foam ring may be needed for stabilization.

How does the lateral or Sims position help in surgeries?

The lateral or Sims position is typically used in renal surgeries or cardiothoracic procedures. It involves positioning the patient on their side, with the specific side of the body on the operating table being designated for the surgery.

What is the primary risk when using the prone position in surgeries?

The prone position poses a risk to the patient's ventilation, as abdominal pressure can impede normal breathing. Additionally, there is a risk of nerve, eye, genital, breast, or spinal injuries.

What is the purpose of using antiseptic solutions during skin preparation?

Antiseptic solutions are used to significantly reduce bacteria on the skin before surgery. The goal is not to sterilize the skin but to minimize microbial presence around the surgical site.

What types of antiseptic agents are commonly used for skin preparation?

Common antiseptic agents include iodine, chlorhexidine gluconate, triclosan, and alcohol. These agents are approved for use on skin and are applied before the surgical procedure.

Why must the surgical team respect the patient's dignity during preparation?

During procedures involving general anesthesia, it is important to respect the patient's dignity by providing a brief explanation before skin preparation begins, maintaining the patient's privacy throughout the process.

What steps are involved in skin preparation before surgery?

Skin preparation involves cleaning the surgical site and surrounding area with antiseptic solutions in a circular motion, starting from the center and moving outward. The area is then allowed to dry before surgical draping.

What is the purpose of surgical drapes or fields?

Surgical drapes create a sterile field around the surgical site, preventing contamination from non-sterile surfaces and providing a controlled environment for the surgical team to work.

How should surgical fields be placed on the patient to ensure sterility?

Surgical fields should be placed carefully, with the sterile side facing the patient and avoiding contact with non-sterile surfaces. Fields must not be moved or repositioned once placed to maintain sterility.

What is the significance of counting surgical instruments and materials after surgery?

Counting surgical instruments and materials, such as needles and gauze, ensures that no items are left inside the patient. This step is crucial for patient safety and to avoid complications post-surgery.