By : Kareem Hamimy 6th year Medical StudentKasr Al Ainy Faculty of Medicine Cairo University
This ppt is designed to give a simple tips for Surgery Interns, observers, Medical students About observation in OR ( Operation Room )
I would like to thank everyone who gave me he opportunity to attend and assist in Surgical operations in Kasr Al Aini (Professors, Lecturers, Residents, Nurses, Workers, patients )
1st : Check The Surgery unit that you are going to attend with. 2nd : Introduce yourself to the Resident, and ask him for the permission to attend. 3rd : Know the schedule of unit . ( when is the grand round, when are the operations ? ) 4th : The day before operation, get the List of patients who are going to OR ). 5th : Try to take a brief History and full Examination to these patients.
6th : Try to read about this Disease, Management, Operative technique, the Night before the Operations, for Maximum benefit
In Kasr Al Ainy, Scrubs are not provided in OR So Dont forget to pack your bag with your clean ironed scrubs.
Before Exiting lockers you have to check that you didn’t miss wearing any of these : Scrubs Overshoes or / Surgical Clogs Overhead Mask
In The OR, You have to be Away from Aseptic Field 50 cm Away from the operation table Away from The Surgical instruments table Away from scrubbed surgeons Away from Anesthesia field Away from troubles Dont ask a surgeon when he is nervous, or when there is complete silence as this is an indicator of a precise part of operations which needs ultimate concentration
While observing, you have to be sure that you know Diagnosis Decision ( & why ) and try to correlate what you read before with what you are observing
Type ( Spinal, Regional, Epidural, General) Technique Intubation ( how ? ) Cannulation ( IV cannula, Central line ) Medications used, Dosage Monitor
Position of the Patient ( Supine, Prone, Hand Extended, Elevated, Lithotomy ) Exposure Antiseptic application Borders, one way strokes Surgical Sheets ( how they are applied ? ) Light ( Direction ? )
Incision Extensions When to extend it ? ( Observe when is this decision taken ) Layers ( what are the layers incised ? )
Traction and Counter Traction Surgical Instruements used And why this specific instruement not the other ?
Important Structures ( Anatomy ? ) Dangerous Areas
Drainage Why Type ( Suction, …) Size Position How ?
Waking the patient ( anaesthesia ) Postoperative care Visiting patient, the next day of operation is essential, try to follow to observe Recovery phase, and if complications occurred, and how to manage
After being Familiar, with the OR, and the operations, You can ask the resident, to scrub in for assistance and better observation
Prof Dr Aly Haseeb : Illustrated Operative Surgery. Browse Symptoms and Signs of Surgical diseases. Oxford Handbook of Clinical Surgery. Basic Surgical Techniques ( R M Kirk ). Essential General Surgical Operations ( R M Kirk ).
Thank YouFor Comments and Further info :Kareemhamimy89@yahoo.co.uk