Chapter 2: Table of Contents
Setting up the Instrument Table
The instruments can only be set up by a sterile surgeon or technician. If only one layer of the instrument pack was opened prior to scrubbing, the second layer can now be opened by the sterile surgeon or sterile technician as the second (inner) layer is considered sterile. Furthermore, since the surgeon is now ‘sterile’, they can cross over the pack with their arms while opening and can stand close to the front of the table if the sterile drape covers the edge of the instrument table.
Once the pack is open, ensure the sterilization marker has changed colour to indicate the pack is sterile. All instruments are on hooks and thus need to be unhooked (some towel clamps can be kept on the hook as you won’t use them all). Papers that were inside the bowls can be discarded or placed underneath the bowls. Account for all the instruments in the pack by comparing to the list found within the pack. Make sure you keep this list (place it under the bowls) so that you can recount all the instruments at the end of the procedure. The gauze sponges need to be counted prior to surgery (and also at the end) to ensure none are left behind in the patient. Surgeons have different preferences on how the instrument pack should be set up.
Final prep solution and saline will be provided by an unsterile assistant. In order to ensure that they do not contaminate your instrument table, hold the container away from your table (NOT overtop the instrument table) during pouring and do not allow the bottle to touch your sterile container. After completing the patient’s final prep with the sponge forceps and gauze, discard the gauze (avoid passing over the instrument table surface, pass the forceps towards the discard bowl from the side instead) and clip the sponge forceps to the edge of your table cover drape as the forceps are considered contaminated (may have touched the patient during the procedure).
Included in the Pack (May differ depending on pack/ clinic):
- Saline bowl
- Disposal bowl
- Final prep container and tray
- Sterility indicator
- List of instruments in pack
- Scalpel handles
- Thumb forceps
- Needle holders
- Carmalt hemostatic forceps
- Crile and Kelly hemostatic forceps
- Mosquito hemostatic forceps
- Towel clamps
- Sponge forceps