 General knowledge

Anticipation (advance thought) - knowledge

 If you know the surgery the surgeon is fine stress free, because he knows that u know.
 Focus , pay attention sa surgery alam mo yong steps the surgeon is stress free.

4 steps
1. Knife blade- open up the skin
2. Bovie- Ready in your hand, as soon (To avoid bloody) (cautery -
3. Retractor- 99% - SELF RETRAINER, ARMY NAVY (SMALL)
4. Forcep- (1 bove in hand other forcep) They basically their fingers, Long fingers grabbing tissue,

Knife blade, Bovie, Retractor, Forcep

 Pay attention in the surgery.

Suture ( if surgeon used suture always prepare) - scissor

Instrument passing
 Closer to the tip, they can be able to feel the instrument to avoid cuts.
 Near the top,
 Retractor- (Paying attention, u should know what type of retractor. You have to anticipate
 Instrument should not pass in flat way, you should able recognize the way they gonna use it.
 Between the thumb and forefinger – Twist
 Important skill- u HAVE TO PAY ATTENTION, LEARN STEPS, PASS INTRUMENTS AS THE SURGEON USE
IT.
 ESU- Electrosurgery unit – Bovie
 William T. Bovie
 Electro surgery- to cauterize a surgical site. To coagulate tissue
 Push the buttom. Growning pad able to used bovie. (apply to patient thigh, arm) active electro
 The power will go to the tissue back to the generator

o
 Cautery- the cauterize the area to avoid bloody
 Bipolar- (Bipolar Forceps) two metal tips, - you don’t need cautery pads,
1. Robot spatula
2. Monopolar scissor
3. Sunction and cautery (middle tip)
 CORD- Robotic cords (robotic instruments itself)

Needles

 Cutting needles- Cut, sharp tape, bladed as it goes downs. Inter tissue
tough tissue. Triangle form
 Taper- Round, blound tip, hindi pointed.

ABSORPTIONS #2 TYPE

 NON- ABSORBABLE- Need i-removed, need bumalik is patient

 ABSORBABLE- kahit di na bumalik si client, kasi ma-absorb na sya.

SUTURES

 Monofilament-( NILON )single strength in suture- (Nonabsorbale) Prolene

dyed blue Ethilon (green) Non absorbable CHROMIC = CUTE , PDS (PURPLE
,gray packaging , Most common Monocryl= clear, absorbable

 Multifilament- multiple strength in suture, single filaments that strings ,

(Silk suture) non absorbable black Ethibond (orange packaging the suture is
green) Non absorbable, Common suture = Vicryl, absorbable white or
purple ) , Fibawire tough suture to break

Reminder: In removing package, pick up the needle. (Para hindi magka buhol-
buhol)
PAAC Consultation- provide appropriate anesthetic,

Walking through surgery

 Turn up on time
 Register in receptionist
 Assist preparing
 Deliver to the OR
 Some questions will be ask
 A cannula will insert in hand, to administer fluids
 Now u are ready to anesthetic
 You will transfer
 VS TAKING
 U WILL WOKE UP IN REVOCERY AREA
 Monitored by the nurse

ANESTHESIA

1. Peripheral nerve block- Regional anesthesia

2. Spinal anesthesia- local anesthetic
3. General Anesthesia