Friday, March 13, 2009

Mock surgery, part trois

Yesterday I was the "surgeon" for Chester's mock procedure.

To don sterile clothing, start with a bonnet covering all of your hair; no cute bangs hanging out please. Then a mask to completely cover nose and mouth. Those of us who wear glasses have a special issue with getting the top of the mask snug so we don't fog up the glasses.

A surgical scrub consists of washing every part of your hands and forearms. You start with the little pick thing and clean under your fingernails. Next, wet hands and use the soap impregnated sponge as follows: consider that your fingers, hands and arms have 4 sides -- front, back, edges. You can scrub by time or by count; I find counting easier. Ten strokes up and down the back of pinkie finger, ten strokes up and down outside edge of pinkie finger, ten strokes up and down palm side of pinkie finger, ten strokes up and down edge between pinkie and ring finger. Repeat for other 4 fingers, then repeat on palm,then distal 1/2 of forearm, then proximal 1/2 of forearm (should take about 5 minutes). Then start all over again with the other hand. Rinse with elbows bent and fingers higher than elbows at all times (so any drips go toward the elbow). Open sterile towel and dry one hand and arm with one side of the towel, other hand and arm with other side of towel, never going back over a clean spot with dirty towel. Try that sometime; it is even harder than it sounds.

Open a sterile gown without letting it touch your clothes, the table, the floor, anything at all, and handle it only from the inside while putting it on. Keep your hands inside the cuffs, no fingers peeking out. You really need a dresser at this point, to stand behind and tie the neck ties without touching the front of the gown, then the waist ties, then a little "tug" at the hem to make it feel straight.

To get the feel for closed gloving, put on an extra large sweatshirt with arms long enough to cover your hands and try putting on rubber dish washing gloves while keeping your fingers covered by sweatshirt sleeve until they are inside the gloves. It is something like that.

Once gowned, hatted, masked and gloved, the surgeon has to stand with hands clasped together in front of the body to remind her not to touch anything that is not sterile. And so I stood until B let me know her patient was deep enough for me to start.

Skin does not feel like any of the materials we practiced on. Sticking a needle through skin is much harder than you would think.

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