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Tips to Remember During Patient and Surgeon Preparation

Chapter 2: Table of Contents

Tips to Remember

  • Clip from the xiphoid to the pubis. Remove all hair around the mammary glands. In male dogs, remove all hair around the prepuce and flush the prepuce with an aqueous solution (not alcohol).
  • Remember to express the urinary bladder. Palpate the bladder and maintain constant pressure while expressing the urinary bladder rather than applying pulsatile pressure.
  • After clipping and vaccuming, remove your labcoat to perform patient preparation.
  • Try not to touch the solution bottle tips with gauzes when pouring the preparation solutions. This potentially contaminates the gauze and the bottle tip.
  • Remember to wear a hat and mask to enter the surgery suite. Your labcoat should already have been removed.
Correct Surgical Posture
  • Position your patient and gather extra materials (gloves, suture, etc.) prior to opening the surgical packs.
  • Position the patient correctly and in an area of the table that will make surgery comfortable for the surgeon. Remember that right-handed surgeons do surgery from the right side of the patient (anesthetist on your left towards the head and instrument table on the right towards the feet such that your dominant hand is towards the instrument table.)
  • Do not cross your arms over the packs while opening them.
  • Grasp the edges of the drapes / packs only to prevent contamination of the inside layers while opening.
  • Ensure that you do not contaminate the gown or drapes while picking up the hand towel and gown from your laparotomy pack.
  • While drying your hands, prevent touching the hand towel on your scrub top and remember to discard the towel without scrunching it up.
Glove Covering Cuff
  • Remember to keep your gown cuffs covered by the gloves and perform open gloving if re-gloving is necessary during the procedure. Your gown cuff is considered contaminated after you have gloved for the first time.
  • Remember not to open the new pack of gloves on your instrument table as it might result in contamination of your instruments during re-gloving.
  • Make sure your gloves are the correct size and that the glove fingertips are not extending (bagging) at the tips of your fingers – this could result in puncture or cutting of the glove tip or decreased tactile sensation.
  • Keep your gloved hands where you can see them… not too close to your mask!
  • Don’t move your instrument table too close to the patient table until your drapes and laparotomy sheet are applied to prevent contamination.
  • Remember to perform a final prep before draping not after.
  • Set up your instrument table prior to draping so your towel clamps are easily accessible when you need them.
  • Count your gauzes, inspect your instruments and wash off the glove powder before draping the patient.
  • Protect / hide your gloves while applying drapes.
  • Drape a long area (well cranial to the expected incision site) in case you need to extend your incision (e.g. hemorrhage from an ovarian pedicle).
  • There is no need to drape wide unless you anticipate placing a drain or abdominal feeding tube

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