Practice English Speaking&Listening with: Passing Surgical Instruments

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Hello everybody. Mike here from Surgtech Academy and today I'm going to

demonstrate basic instrument passing with and without hand signals. At this

point we have already ready to go, the patient is prepped and draped, cords are

thrown off, and the surgeon is ready to start. Now the first thing you want to

remember is that you want to make sure the Mayo stand is at an acceptable level

ergonomically and it's still sterile. We can't have the Mayo stand above chest

level or below waist level as those areas are contaminated. So you may need

your circulator to get you a step stool to go higher or you may need anesthesia

to raise the O.R. bed just to make sure that we're sterile and the Mayo stand is

comfortable and doesn't cause back pain. Before we get started I want to spend a

second teaching my surgeons everything they need to know when participating in

this exercise. As the surgeon your main jobs are to verbally ask for instruments

and to use hand signals to ask for instruments. And those three main hand

signals are scissors, tissue forceps, and stitch. Alright, so scissors, tissue

forceps, and stitch. And there actually could be a fourth visual which is please

just give me what I need! But that might take a while for you to get that one. And

there's also two main hand positions that surgeons receive the instrument. The

first way is the easiest where you stand there with your hand extended at waist

level like you're going to shake somebody's hand. Most instruments are

received using this method. The second way is to shape your hand like you're

putting a book on the shelf. We use this hand shape for the scalpel and the

tissue forceps. Now when teaching instrument passing I

tell my students to follow four main rules. Right. And those rules are to pass

firmly, and then middle finger on the box lock, pass the instrument straight up and

down, or pass it in position to use. So for most of our basic instruments it

looks like this. So I'm gonna start with the scissors. Straight up and down, my

middle fingers on the box lock, and I'm gonna pass firmly. Surgeon's hand is

like there shaking your hand. Just like that, alright.

Kocher, middle finger on the box lock, straight up and down, pass firmly. You

hear that cool little click? Allis forceps, middle finger on the box

lock. pass firmly. Kelly, guess what, middle finger on the box lock, straight

up and down, pass firmly. Alright even a Babcock, middle finger on the box lock,

pass firmly. Now it's important to try and stay away from the tips of the

instruments as it is the sharpest and you could cut your glove. Also remember

that curved instruments are passed with a tips curving toward the midline of the

surgeon and press firmly so that the surgeons grasp reflex is initiated. You

saw that a couple of times I was passing instruments that my grasp reflex

automatically tried to grasp the instrument. Alright, now like everything

else in surgery, there are exceptions to the rule. There are a couple of

instruments on my Mayo stand that are unique. Now the first one I want to talk

about is the scalpel. Now the first thing I still tell my students is to avoid the

tip as this will inevitably cut your finger and I will have to send you to

the emergency room for stitches. So I have them grab the top of the scalpel

and instead of placing firmly in the surgeons palm we're gonna place it in

the webbing between the thumb and the index finger. It places just like this.

Alright I'll show you that again. Sharp needle down, ring finger right in the

middle, placing it in the webbing. Now the second unique instruments are tissue

forceps. Now these are very similar to the scalpel. I tend to grab the

instrument mid-instrument and place it back in the surgeons webbing between the

thumb and the index finger. Just like this.

Alright, again. Thumb, middle finger, passing it right into the webbing. And then

the last instrument I want to pass is the needle holder. It is very similar to

most of the basic instruments except that we have a needle direction to think

about. I tell my students to make sure that the needle tip is point toward the

midline and at the surgeons heart. Alright. So even still my finger is at the box

lock, I'm going to point it, I'm gonna pretend point it towards the surgeon. Me.

Nice and firm. And it's still, they have that grasp reflex. Now if you want to

tell them you don't have to tell them to point it at the surgeon's heart. You can

pick any anatomy you want to. But that visual seems to work for my students.

And well, that's it passing of the basic instruments with and without hand

signals. This is Mike from Surgtech Academy wishing you a great day in

surgery and reminding you to be a superstar in your O.R.

The Description of Passing Surgical Instruments