Basic Skills for the OR

Always wear appropriate attire (head cover, mask, eye protection, shoe covers, sterile gown, and sterile gloves) when working within a sterile field.

Opening sterile surgical instrument packs depends on how the pack is packaged.

In most operating rooms. We will package these either in rigid containers or in paper. It's very common to use paper, paper has to be used either two-ply, or you wrap it in two layers. When we look at a surgical package, the way that we tell whether or not it's been sterilized, is by the external chemical indicator tape. Now, each method of sterilization whether it be steam, EtO gas or Sterrad, has its own chemical indicators. The only thing that chemical indicator is, is a color change ink - it changes color when it gets to the proper parameters.

What we have here is a steam sterilized package. We see the black lines appear on the tape. Although the black lines are an indicator, they don't guarantee sterility. What they tell us is that this package was exposed to steam, but it doesn't tell us for how long or at what temperature, so it's not the only method that we will use.

We look at the outside package and like all packages we want to check its integrity. We look for holes, tears and watermarks. We look to see that our package has changed from the white lines of the tape to black. Then we look at the sticker that's on here.

The sticker usually holds three key pieces of information, the autoclave, the low number, and the Julian date. The Julian date is the days of the year from 1-365. Since this year is a leap year - 2020, we will actually have 1-366. Before we open up a sterile supply, we need to make sure that we're ready to do so. I would need to be in sterile attire with a mask on. Anytime that we open sterile equipment we need to be wearing a mask.

Note: To avoid contamination, run your hand over the surface to check for moisture before placing the wrapped package down.

This package is bolted in the envelope bow. We want to orient the package onto the mayo stand. We want to bring it as close to us as we can, and we want to find that courtesy tab. The courtesy tab tells us in which direction we're going to open. And in this package, we're going to open away from us, side-to-side, and then back towards us. The first thing we want to do is confirm that our chemical indicator shape has changed, then remove or tear the tape without contaminating the package.

When they first flap if we will hold the tip of the folded back corner and move it to the back without contaminating,the we will then do the side corner making sure to use the left hand for the left tip in the right hand to the right corner without crossing the sterile field.

and now the we will take the last flap and pull it towards them making sure we does not cross the sterile field.

We will now step back without putting back to the sterile field, and let the third people complete the opening of the pack.