Opening of Sets, instruments & stock
anesthesiologist prefer antiseptic
Before patient’s come in:
CIRCULATING NURSE
 Prep table
 Spinal table
SCRUB NURSE:
 Back table
 Mayo table
PREP TABLE: CIRCULATING NURSE
 After checking all the materials that
needed for the procedure, open the set
& check if it’s sterile, intact, ready to
use.
 Surgical prep- open from the farthest
part, side, & near you. Make sure not to
touch sterile part of the packaging make
sure that you cover the table entirely.
 In order to use or prepare the prep
table use pick up forcep. Inside part of
the packaging is STERILE, ourside part
is UNSTERILE.
 There is no specific preparation for the
prep table, as long all materials are
available and you know how to use it.
 THINGS THAT SHOULD BE IN PREP
TABLE:
 2 Towels
 6 OS
 Kidney basin = 20 cherry balls (right
side) for cleanser, 20 cherry balls (left
side) for betadine antiseptic.
 Prep for cleanser:
 Wet the cherry balls with sterile water
 Sterile water is in the bottle twist it and
pour it on cherry balls make sure it will
not touch the sterile area.
 Then betadine cleanser (bubbles) pour
and make sure it will not mix on
antiseptic
 If catheterization is needed:
 Add 5 cherry balls on betadine
antiseptic .
 for anesthesia site, some
betadine prepare and add 5 cherry
balls with betadine antiseptic.
 Number of cherry balls is depend on the
site and procedure.
 3 Sterile gloves for catheterization and
skin prep- make sure not to touch
inside when opening the package.
- when putting the gloves in the
table, you can use pickup forcep or
dropping it without touching the
sterile area.
 Foley catheter (prn) with plastic
 KY jelly at the center of kidney basin
 Urinary bag – attach on OR table
 10 cc syringe to inflate the balloon in
FC, prepare sterile water from 1L get
10cc. put it under the prep table
(UNSTERILE).
SPINAL TABLE/ANESTHESIA TABLE: CIRC NURSE
 Use pickup forcep
 Clear the table first. Open the set.
 Locate the opening of pillow case.
Clamp both sides then insert or dress
the anesthesia table with pillow case.
Stabilize the table or don’t touch the
table with pickup forcep.
 Open the package, outside part (hold),
ulaon sa table or use pickup forcep.
 Open the set w/ pickup forcep place on
the table & open.
 Towel
 4 pcs 4x4 gauze pad
 Eye sheet when packaging, make sure
the hole is facing outward)
 Sterile gloves (consider the size of
anesthesiologist)
 5cc syringe (drop on the table)
 1 cc syringe
 Spinal set (don’t open)
 Medicine which anesthesiologist will
give. (ask anesthesiologist about the
med)
 Set aside and keep the spianl needle
sterile.
 pouring solution (sterile water)
away from the instruments
- Open possible instruments needed
SCRUB NURSE:

 Before opening the drums make sure

PREPARATION OF INDUCTION OF ANESTHESIA
that you have enough space.
(SPINAL):
 When preparing back & mayo table
make sure to clear the table first. CIRCULATING NURSE:

BACK TABLE: SCRUB NURSE  Position pt side lying position

 Before induction of anesthesia
 Make sure to soak all instruments
circulating nurse should pray (Prayer
needed.
before surgery)
 Use pickup forcep (2) to open the set.
 Some anesthesiologist used betadine or
 Pillow case, locate the opening then
spray.
put it or insert it on the mayo table (2).
 After praying next is Skin Preparation:
 Major drums:
 Prep table, kick bucket (bin), light
- (3) gowns
 When pt is inside the OR attach pt’s
- Ordinary sheet (lower & upper
monitor and take initial vital signs
extremities)
(outside and inside OR)
- Lap sheet/leggings
 Circulating nurse is unsterile and not Skin Preparation:
allowed to touch the sterile area.
 Pickup forcep
 3 sterile gloves on back table (surgeon,
 Antiseptic first (left side of kidney basin)
asst. surgeon, scrub nurse)
- 4 cherry balls betadine
 Right side sterile gloves of surgeon &
 Start in marking area
asst. surgeon
- Circular, circular, circular, inside,
 Left side sterile gloves of scrub
outside, square
nurse/student nurse
- Down in kick bucket
 Powder for gloving (sterile powder)
- The last cherry ball start in the up to
MAYO TABLE: SCRUB NURSE down (straight line)
- Unsterile forcep put sa dalom ka
BASIC SET:
prep table or sa box.
 When opening the set hold the pan in  Put the chair near in the pt for the
unsterile area. doctor can sit down to induct the
 Wrap the wrapper around your arm anesthesia.
when holding or carrying the pan to the  After induction of anesthesia &
mayo table. medications, TAKE NOTE: TIME
 2/3 or 4x8 (10) open slowly drop in the (Anesthesia Started) = form & board
mayo table/use pickup forcep
 (2) Blade 20 – drop
 Poole drain and cautery pen Catheterization: CIRCULATING NURSE:
 (1-2) big & small needle holder
 Before cleaning make sure to open the
 Metzenbaum, mayo, suture, bandage
foley catheter & drip to KY Jelly
scissors (should be sterilized)
 Betadine antiseptic (5 cherry balls)
- rinse (sterile water), put in mayo
- Use non-dominant hand when
table using pickup forcep, when
getting cherry balls
Male:
 Hold the penis with left hand
 1st Clean with cherry balls circular
motion down to shaft
 2nd – center down to shafr to lower
abdomen
 3rd – center, down to shaft away from
the leg (half)
 4th – center, down to shaft, near leg
from you (half)
 5th - center & shaft (drop every cherry
balls after use)
Female:
 1st – from clitoris down
 2nd – above muns pubis
 3rd – center, away from the leg (mid
thigh)
 4th – center, near leg (midthigh)
 5th – center then down
Inserting the Catheter:
 Make sure the gloves are clean
 Get the Foley Cathter and balimbod
(the tube of urine bag, palapos sa leg
sang pt) and prepare 10cc syringe with
sterile water for inflation of balloon =
Circulating nurse
 For female look for her meatus
 Insert the FC, insert the urine tube of
urine bag then inflate 10cc push
 Withdraw & drop
Abdominal Preparation: CIRCULATING NURSE
 Abdominal CS patient
 Wear gloves then prepare 3 cleanser
(cherry balls)
- 1st – pusod
- 2nd – (2) incision site (to incision site
then circular)
- 3rd – (circular, incision, far leg to
midthigh)
- 4th – (circular, incision, near leg to
center)
 Do in 3 CYCLES
 Put towel the tap to remove cleanser
then drop
 Prepare 6 os (wet with sterile water)
- 1st – clean pusod
- 2nd – 2 OS same stroke sa
cleanser
- 3rd – 2 OS same stroke to
farthest leg
- 4th – same then near leg to
center
 Towel – clean or tap/ remove
 Remove 1st glove
 Wear 2nd glove
 Prepare 3 antiseptic (cherry balls)
- 1st – pusod
- 2nd – (2) same stroke
- 3rd – (2) same to farthest leg
- 4th – (2) same to near leg
 Do it 3 CYCLES
 For the 3rd final cycle @ incision site
with left hand.
Wheel in: during endorsement
1. Identify the patient
2. Check for contraptions
3. Check initial vital signs
4. Receive endorsement
5. Check perioperative checklist
For SCRUB NURSE:
 When the surgeon is not around scrub
nurse can scrub already. Hand
scrubbing, hand prepping, PPE, and
proceed to gowning. Wear first glove,
then just apply the sterilium (make
sure to wet your first glove with
sterillium).
 After hand prepping, next is gowning
make sure to locate the arm hole of the
gown to prevent being unsterile. And
wear it slowly and let the circulating
nurse fix it.
 Next, gloving. Hold in the opening then
pakulbon then wear.
 Before folding the drapes in the back
table, proceed to mayo table to count
with the circulating nurse.
- Clear the table. (you are the
one who pack the instruments)
- Don’t dangle the
drape/wrapper of the
instruments then open. Then
flaten the sheet in the mayo
table.
- Put the rolled towel beside
mayo table then dira
natungtung/na anchor ang mga
instruments sa rolled towel.
- Separate the forceps, needle
holder by size, ovum forcep,
tissue forcep, blade handle
(gatunog magbutang and
magremove sa dalom), adson,
thumb forcep, mez, mayo,
suture, bandage, umbilical,
army navy retractor, blades
(insert na sa blade holder using
needle holder then i hide sa
may towel lapit sa may
instruments).
 Poole drain & cautery pen –
butang sa towel clip
 OR light handle
Back table:
 Gown is located
 Make sure that the gown doesn’t
dangle
 Fold the towel with opening outside.
 Ordinary sheet (roll the center to the
end)
 Lap sheet (fold every end) baliskadon
mag hatag sa surgeon.
Assisting the surgeon in gowning and gloving:
 Locate the opening facing to the
surgeon.
 Circulating nurse will tie or fix the
gown.
 Gloving- fingers inside away ang thumb.
Then offer sa surgeon.
DRAPING: SCRUB NURSE

INITIAL COUNT: 1. Towels (4) – ipalibot sa area where

operahan ang pt for example abdomen
 (10) - 2/3 (fold)
area, then clip with towel clips (4).
 (12)- Mosquito curved
2. Ordinary sheet (down) clip with towel
 (6) – mosquito straight
clip (ang ga clip man sa towel)
 (6) - allis forcep
3. Ordinary sheet (up) clip with towel clip
 (6) – kelly forcep
(ang ga clip man sa towel)
 (2)- ovum forcep
4. Lap sheet (incision area)
 (4 or 5) – needle holder
 (1) – thumb forcep
 (2) – tissue forcep
 (1) – adson forcep
 (2) – blade handle #4 blade #20
 Scissors:
 (1) – metzembaum scissor
 (1) – mayo scissor
 (1) – suture scissor
 (1) – bandage scissor
 (1) – umbilical scissor
 Retractors:
 (2) – army navy
 (2) – richardson
 (5) – towel clips