KULIAH

KEPANITERAAN UMUM
BEDAH 2019
Soni Wijaya
FK UNTAR
Topik
• Keterampilan Dasar Tekhnik Bedah
• Scrubing
• Gowning and gloving
• Theatre Ettiquete
• Instrument Handling
• Knotting
• Suturing

• Keterampilan Pengolahan Masalah dan Pencatatan

• Anamnesa
• Pemeriksaan fisik
• Modalitas tambahan (Penunjang)
• Alur berpikir dan Penegakan Diagnosa
• Summary
Keterampilan Dasar - Scrubbing
• Adjust water and collect antiseptic solution, don’t mix
two solutions, use elbow then
• Avoid splashing water
• Nail brush only for nails and hand creases and down
strokes only
• Scrub from hands towards elbow, must not come
back
• 2 minutes hands to above elbow, rinse by rotation
• 1 min hands to below elbow, rinse by rotation
• 2 minutes above wrist, followed hand washing by
WHO, rinse by rotation
• Keep hands up above the umbilical level
Drying hands and elbow
Don’t open paper towel
Sponge and not rub
Keep towel folded
 Keterampilan Dasar
Gowning & Gloving
Objective Closed technique

Notification Must to know your hand size

Half size larger underneath for double gloving
Half size larger above if double gloving after complete gowning

Practice Hold gown by pinch grip

Gowning Don’t shake
Slip hand to sleeve
Keeps hands in
Ask assistance to tie on the back side
• Practice Gloving
• Keeps hand in
• Pinch the glove by the hand inside the sleeve, thumb to thumb
• Pull the sleeve slightly above wrist joint (still on hand)
• Ask scrubbed person to hold the anterior tie and walk around though the back side and tied up
• Hands on folded between nipple and umbilicus
•

• Wallking in theatre
• Clean to clean, dirty to dirty

• Intra operative glove changing

• Ask assistance to grip the glove and sleeve, and pull together, so the hands still
inside the sleeve

• Remove the Gown

• Right hand hold left sleeve. Left hand hold right sleeve. Straighten the elbows and
then cross and remove.

• Remove the Glove

• Dirty to dirty, clean to clean and remove the glove

• Post Operative Protocol

• Remove the mask, the visor, wash and dry your hands
Keterampilan Dasar – Theatre Ettiquete
• Objective
• To minimize infection
• To protect health personnel
• To improve wound healing
• To minimize disability, morbidity & mortality
• To reduce the cost of hospital care

• Preparation, night before

• Read up the operation
• Cut and clean nails, no artificial nails or eyelash
• Shower at home
• Entering theatre
• Leave phones, etc
• Remove and change to theatre clothes except pants and bra.
• Tuck shirt in
• Cap hoods, cover all hair
• Masks, over the nose, don’t turn head away while talk, cough and sneeze
• Eye Protection
• Cuts, cover with waterproof dressing
• Jewelry, bracelet, watch, remove all accessories along hand and forearm

• Theatre suite

• Anesthetic room
• Patient exit
• Scrub room, enter through this door
Keterampilan Dasar – Theatre Ettiquete
• Objective
• To minimize infection
• To protect health personnel
• To improve wound healing
• To minimize disability, morbidity & mortality
• To reduce the cost of hospital care

• Preparation, night before

• Read up the operation
• Cut and clean nails, no artificial nails or eyelash
• Shower at home