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XXV/V%  @{WATAUGAMEDICALCENTER@OPERATINGROOM@xx}PRECEPTORCHECKLISTPrecepteeName򀀀 x *q ddd Xdd Xdd X(#(#q,dd ,` dd +   .      :  DateCompleted   :  Week1          0 l Chapter1Test J ldld   J  0 l Chapter2Test  N ldld    N  0 l Chapter7Test  ldld     0 l SeekandFindList#1 ^ldld   ^ 0 l ActivityRecordCompletedandSigned bldld   b Week2      0 l Chapter4Test rldld   r 0 l Chapter5Test vldld   v 0 l Chapter6Test *ldld   * 0 l SeekandFindList#2 . ldld   .! 0 l ActivityRecordCompletedandSigned "ldld   # Week3  >$   >% 0 l Chapter9Test B&ldld   B' 0 l Chapter3Test (ldld   ) 0 l Chapter8Test R*ldld   R+ 0 l Chapter10Test  V,ldld    V- 󀀀SeekandFindList#3   ".    "/ 0 l ActivityRecordCompletedandSigned f#!0ldld   f#!1 Week412  $j"2   $j"3 0 l Chapter11Test ldld    0 l Chapter12Test z'"%6ldld   z'"%7 0 l SeekandFindList#4,5,6 (~&8ldld   (~&9 0 l Fire,MalignantHyperthermia,Cardiac, 2*': DisasterTests *p(;ldld   2*'< 0 l ActivityRecordCompletedandSigned $,)=ldld   $,)> 0 l PracticalEvaluation -(+?ldld   -(+@ 0 l CompletesCBOOrientationProgram .,Aldld  .,B  Preceptortoinitialwhereappropriate j0.C Ї@{WATAUGAMEDICALCENTER@OPERATINGROOM@hhSELFASSESSMENTInstructions:Placea C and/or S ineachboxtoindicatelevel  ofproficiencyinthecirculatingandscrubroles.Rateyourskillsfrom1to4usingthefollowingscale.  zX X0  1Noexperience.Youhaveneverdonethestatedtask/skill (#(# 0  2Minimalexperience.Youhaveperformedthetask/skillinfrequently. (#(# 0  3Moderateexperience.Youcanperformthetask/skillindependentlyπwiththehelpofresourceperson. (#(# 0  4Extensiveexperience.Youcanperformthetask/skillproficientlyπwithoutassistance. (#(# *` dddd ` dd (#(#`,dd ,dd +      @,Rating  H  @PPDTask/Skill  H    H  PERIOPERATIVEPATIENTASSESSMENT  H      1.PatientInterview      @ 2.Developnursingdiagnosisandcareplan  @   0  MONITORINGVENTILATION,CIRCULATION,ANDINTAKEANDOUTPUT  0    Ѐ 1.Assistanesthesiapersonnelduringinduction     8  Ѐ2.Applicationofcardiacmonitorelectrodes  8!   (" Ѐ3.Applicationofantiemboliticcompressionunits  (#   p$ 0  a.DVT p% " "   & 0  b.TEDhose ' " "   X( Ѐ4.Operatedefibrillator  X)   H* Ѐ5.Readcardiacmonitors  H+   , Ѐ6.Useautomaticbloodpressuremonitors  -   0. Ѐ7.Administrationofbloodandbloodproducts  0/   x 0 Ѐ8.Urinarybladdercatheterization  x 1    h2 Ѐ9.Asepticconnectionofdrainagedevices   h3   "4 10.MonitoringpatientunderIVconscioussedation/localπanesthetic  "7 6   #!7  PRACTICEASEPTICTECHNIQUE  #!8   /%"9 1.Propersurgicalattire  /%":   w&$; 2.Surgicalhandscrub  w&$<   'g%= 3.Gowningandgloving  'g%>   )&? 0  a.closedglovingself )&@ " "   O*'A 0  b.openglovingselfandothers O*'B " "   +?)C 4.Creatingandmaintainingsterilefield  +?)D   ,*E 5.Preoperativeskinpreparation  ,*F   '.+G 6.Universalprecautions  '.+H   o/-I 7.Decontaminatinginstruments  o/-J   d  8.Wrappingandpackagingitemsforsterilization  d    9.Verificationofthesterilizationprocess     L  HANDLINGEQUIPMENT  L   L Ѐ1.Electrosurgicalunits  L     0  a.monopolar,ValleyLab,Force2,sse2k,sse3b   " "   4   0  b.bipolar 4   " "   | $  0  c.Argonbeamcoagulator,Birtcher | $ " "    l  0  d.Wolfmonopolar  l  " "     0  e.Elmedmonopolar   " "   T  Ѐ2.Microscopes  T    D  Ѐ3.SteamSterilizer  D     Ѐ4.EKGmonitor     , Ѐ5.Laser  ,   t 0  a.CO2 t " "   d Ѐ6.Laparoscope  d    Ѐ7.Insufflator      L! Ѐ8.Suction/IrrigatorsGYN  L"   <# Ѐ9.Pneumatictourniquet  <$   % 10.Poweredsurgicalinstruments  &   $' 11.Irrigationandaspirationw/Avit  $(   l) 12.Phacounit  l*   \+ 13.Hypo/hyperthermiaunits  \,   - 14.Fiberopticlightsourcesandcords  .   D / 15.Chestdrainageunits  D 0   !41 16.Stirrups:Crutch,hanging,Allen  !42   "| 3 17.Tables  "| 4   $!5 18.Fracturetable,Telos  $!6   d% #7  GASTROINTESTINALSURGICALPROCEDURES  d% #8   &d$9 Ѐ1.Appendectomy  &d$:   (%; Ѐ2.Bowelresection  (%<   L)&= 0  a.colectomy L)&> " "   *<(? 0  b.colostomy *<(@ " "   +)A 0  c.sigmoidresection +)B " "   $-*C 0  d.lowanteriorwithstirrups $-*D " "   l.,E Ѐ3.Cholecystectomy  l.,F   /\-G Ѐ4.Feedinggastrostomy  /\-H   d  5.Esophagealresection  d    Ѐ6.Esophagoscopy     L Ѐ7.Gastrectomy  L   < Ѐ8.Gastroplasty  <      GASTROINTESTINALSURGICALPROCEDURES(CONT'D)      4   Ѐ9.Gastroscopy(EGD)  4     | $  10.Hemorrhoidectomy  | $    l  11.Laparoscopiccholecystectomy   l      12.Liver      T  0  a.biopsy T  " "   D  13.Pancreatectomy  D     14.Splenectomy     , 15.Hiatalherniorrhaphy  ,   t 16.Vagotomy/Pyloroplasty  t   d 17.Autosutureinstruments  d    0  a.nondisposable   " "   L! 0  b.disposable L" " "   <#  GENITOURINARYSURGICALPROCEDURES  <$   % Ѐ1.Ureteroscopy:flexibleandrigid  &   4' Ѐ2.Cystoscopy  4(   |$) Ѐ3.Cystotomy  |$*   l+ Ѐ4.Hydrocelectomy  l,    - Ѐ5.Ilealloop   .   T / Ѐ6.MarshallMarchettiKrantz  T 0   !D1 Ѐ7.Nephrectomy  !D2   " 3 Ѐ8.Penileprothesis,inflatable  " 4   ,$!5 Ѐ9.Burchprocedure  ,$!6   t%#7 10.Prostatectomy  t%#8   &d$9 0  a.Retropubicradical &d$: " "   (%; 0  b.Suprapubic (%< " "   L)&= 0  c.Transurethralresection L)&> " "   *<(? 11.RAZ  *<(@   +)A 12.Cystoscopy  +)B   $-*C 0  a.retrogrades $-*D " "   l.,E 0  b.stonemanipulation l.,F " "   /\-G 13.Ureterolithotomy  /\-H   d  REPRODUCTIVESYSTEMSURGICALPROCEDURES  d     1.Abdominalhysterectomy     l Ѐ2.Anterior/Posteriorrepair  l   \ Ѐ3.Augmentationmammoplasty  \     Ѐ4.Breastbiopsy      D   Ѐ5.Caesareansection  D      4   REPRODUCTIVESYSTEMSURGICALPROCEDURES(cont'd)   4     Ѐ6.D&C      ,  Ѐ7.Laserlaparoscopy  ,    t  Ѐ8.Mastectomy  t    d  Ѐ9.Tubalreanastomosis  d     10.Laparoscopictubal(cliporcautery)     L 11.Peritoneoscopy/laparoscopy  L   < 12.Laparoscopicallyassistedvaginalhysterectomy  <    13.Tubalirrigation,Cohen'scannula     $ 14.Tuballigation,laparotomy  $    l! 15.Vaginalhysterectomy  l"   \# 16.Vasectomy  \$   %  OTHERPROCEDURES  &   T' 1.Transvenouspacemaker  T(   D) 2.Colonoscopy  D*   + 3.Sigmoidoscopy  ,   ,- 4.EGD  ,.   t / 5.Choledochoscope  t 0   !d1 6.Hysteroscope  !d2   # 3  RESPIRATORYSYSTEMSURGICALPROCEDURES  # 4   \$"5 1.Bronchoscopy  \$"6   %L#7 2.Firstribresection  %L#8   &$9 3.Laryngoscopy  &$:   4(%; 4.Lobectomy  4(%<   |)$'= 5.Mediastinoscopy  |)$'>   *l(? 6.Pneumonectomy  *l(@    ,)A 7.Thoracotomy   ,)B   T-*C 8.Thorascopy  T-*D   .D,E 9.Tracheotomy  .D,F   /-G  PERIPHERALVASCULARSYSTEMSURGICALPROCEDURES  /-H   d Ѐ1.AbdominalAorticAneurysm  d    Ѐ2.Aortafemoralbypass     L Ѐ3.Axillofemoralbypass  L   < Ѐ4.Carotidendarterectomy  <     Ѐ5.Embolectomy      $   Ѐ6.FemoralPoplitealbypass  $     l   Ѐ7.Insertionvenacavalfilter  l     \  Ѐ8.Saphenousveinligation/stripping   \       PERIPHERALVASCULARSYSTEMSURGICALPROCEDURES(cont'd)      T  Ѐ9.Dialysisaccessgraft/fistula  T    D  10.Autotransfuser  D      NEUROLOGICALSYSTEMSURGICALPROCEDURES     < 1.Lumbarlaminectomy  <   ,  SENSORYSYSTEMSURGICALPROCEDURES  ,    Ѐ1.Acousticneuroma     $ Ѐ2.Blepharoplasty  $    l! Ѐ3.Cataractextraction  l"   \# Ѐ4.Cornealtransplant  \$   % Ѐ5.Enucleation  &   D' Ѐ6.Facialnervedecompression  D(   4) Ѐ7.Glomustumor  4*   |+ Ѐ8.Intraocularlensimplant  |,   - Ѐ9.Labyrinthectomy  .   d / 10.Mastoidectomy  d 0   !T1 11.Myringotomywitheartubeinsertion  !T2   " 3 12.Rhytidectomy  " 4   <$!5 13.Scleralbuckle  <$!6   %,#7 14.Stapedectomy  %,#8   &t$9 15.Strabismus  &t$:   (%; 16.Tonsillectomyandadenoidectomy  (%<   \)'= 17.Tearductexploration  \)'>   *L(? 18.Tympanoplasty  *L(@   +)A 19.Vitrectomy  +)B   4-*C  MUSCULOSKELETALSYSTEMPROCEDURES  4-*D   .4,E Ѐ1.Amputation  .4,F   /|-G Ѐ2.Archbars  /|-H М  d Ѐ3.Arthroscopy  d    0  a.ACLreconstruction  " "   L 0  b.Ankle L " "   < 0  c.Knee < " "     0  d.Shoulder   " "   $   0  e.TMJ $   " "   l   0  f.Elbow l  " "    \  Ѐ4.Arthroscope,shaver,charactergenerator,picturetaker   \      Ѐ5.Bunionectomy      D  Ѐ6.Carpaltunnelsyndrome  D    4   MUSCULOSKELETALSYSTEMPROCEDURES(cont'd)  4      7.Closedreduction     < Ѐ8.Compressionhippinning,VersaFX  <   , Ѐ9.Externalfixationdevices:EBI,monotube  ,   t 10.Thompsonprosthesis  t    11.ModularMoore      \! 12.HipreconstructionHarris/Gallante  \"   L# 0  a.withcement L$ " "   % 0  b.withoutcement & " "   4' 13.Intermedullarynailing,Kuntscher  4(   |$) 14.ZMSintermedullarynailingFemur/Tibia  |$*   l+ 15.KneereconstructionMiller/Gallante  l,    - 16.Knowlespins   .   T / 17.Ligamentreconstruction  T 0   !D1 18.Mandibularosteotomy  !D2   " 3 19.Maxillaryosteotomy  " 4   ,$!5 20.ORIFoffractures  ,$!6   t%#7 21.Synthesset  t%#8   &d$9 22.Shoulderreconstruction  &d$:   (%; 23.MagnaFxcannulatedhipscrews  (%<   L)&= 24.ECTset  L)&>   *<(? 25.Silasticimplants  *<(@   +)A 26.Skeletaltraction  +)B   $-*C 27.Tendonrepair  $-*D   l.,E 28.Tibialosteotomy  l.,F   /\-G 29.Zygomaticfracture  /\-H V XX    d  ENDOCRINE/LYMPHATICSYSTEMPROCEDURES  d   l 1.Adrenalectomy  l    2.Axillarynodedissection     L 3.Parathyroidectomy  L   D   4.RadicalNeckdissection  D        5.Staginglaparotomy        $  6.Thyroidectomy  $  X}X  z @{WATAUGAMEDICALCENTER@OPERATINGROOM@  ORLINGO BUGJUICENOT anextractfromfliesandmosquitoes, ! 0  BUT d#(#(# 0  Asolutionusedforirrigationofawoundforpurposesofusingantibioticstopically.Itusuallyconsistsofamixtureofphysiologicsolution(saline)andantibioticdrugsaddedasspecifiedbythesurgeon.Theproportionofthedrugstothesolutionwillvary.Thissolutionwillbepreparedbythecirculatingnurse. (#(# 0  Usageofsolutionischartedonthe IntraoperativeNursing T!+ Record ,butthewords"bugjuice"arenottheonesused."l,(#(# 0  0` (#(#0 ` (#` (#0 (# (#(AKA: "Irrigation" )#.(#(# Ѐ CHRISTMASTREENOT adecorationfortheholidays, <% 0 0  BUT &"2(#(# 0  Ametalholdershapedlikean "L" whichholdsanesthesia \(#4 tubing (#(# 0  OR *&7(#(# 0  Ametaladapterthatfitsonasyringetoenableittofitintoacatheter. (#(#  -$);  STIRRUPSNOT anaccessoryforyourfavoritehorse,  0  BUT@(#(#  0  Operatingroomtableaccessoriesthatareattachedtothe   tabletofunctionassupportsforthepatient'slegsandfeetwhenin LITHOTOMY position.Thereareseveraltypes.` (#(#  PULLINGORPICKINGYOURCASENOT anattempttomoveacrate  @ 0  BUT  (#(# 0  Obtainingallsupplies,positioningequipment, `  instrumentationandsoforthrequiredforaparticularsurgicalprocedureusingthedoctor'spreferencecardsorserviceprocedurebooksasareference. (#(#  2CLOSINGNOT necessarilycompletingthepurchaseofanewhouse 8 0  BUT(#(#  0  Thetimeatwhichtheprimaryportionoftheprocedurehasbeencompletedandthebeginningstepsaretakentoclosethevariouslayersofthesurgicalwound. (#(#  TURNOVERTIMENOT thetimetochangetotheothersideofthe x! 0  cassettetape. (#(# 0  BUT $(#(# 0  Theamountoftimethathaselapsedbetweenthetimeone `"& patientleavestheroomfollowingaprocedureandanotherpatientisbroughtintothesameroomforthenextcase. (#(#  FROZENSECTIONNOT themicrowavefoodaisleatthegrocery % * 0  store (#(# 0  BUT'(#-(#(#  0  Amethodofpreparingasurgicalspecimenformicroscopic h)$/ examination.Thistissueisrapidlyfrozen,thenslicedextremelythinsoitcanbebettervisualizedunderhighmagnification.Thisisusuallydonewhencancerissuspectedorpositiveimmediateidentificationofaspecimenisneeded. (#(#  .h)5  HEADLIGHTNOT oneoftheglassglobesatthefrontofacar  0  BUT@(#(# 0  Apowerfulfiberopticlightsourcewornonthesurgeon's   headduringanoperationtoincreaseandfocustheilluminationontheoperativefield. (#(#  BEANBAGNOT somethingtothrowthroughaholeatthecarnival  @ 0  BUT   (#(# 0  Apositioningsupportcalleda vacpac thatismade `  functionalbyapplyingsuctiontothesuctionpluginlet.Thiscausesthe vacpac tomoldtothedesiredshapeand   supportthepatient'sposition. (#(#  FLASHNOT thetermusedtodescribeastreakerrunningthrough H  0  thepark (#(#  3  P  FLASH(cont.d)   0  BUT  p(#(# 0  Thetermusedtodescribeamethodofsteamsterilization.Autoclavesarelocatedwithineachcore,aresmallinsize,anddesignedtosterilizeinstrumentsandotheritems.Thecycleforsterilizationisfiveminuteswithatemperatureof270(f)andunderthepressureof30lbspersquareinch.(PSI) (#(# 0  Thetimingcycleontheseunitscanbeadjustedifalongersterilizingcycleiswarranted. (#(# 0  (ie.mixingtypesofmaterialsorinstrumentshavingcodingtapeneedalongercycle) (#(#  GASNOT somethingusedtoheatyourhouse '`", 0  BUT(#.(#(# 0  Atypeofsterilizingagentcalledethyleneoxidegas(EO). 0*%0 Itisusedtosterilizeitemsthatcannotbesteamsterilized.Itisadministeredduringthesterilizationcycleatatemperatureof150(f).Iftheitemisgaspermeable,itmustbeadditionallyairtreatedbyanotherdevice(aerator)sothattheresidualethyleneoxideis .h)5 dispelled.Theresidualgasishazardoustopatientsandthestaffdealingwithitifnotremovedbyaeration.Examplesofitems"gassed":rubbergoods,heatsensitiveitems,thosethatwouldmelt. (#(# @{ WATAUGAMEDICALCENTER p @ uTHINGSAPACUNURSENEEDSTOKNOW 8 @\ \ xBUTMAYNOTHAVETIMETOASKName:0 ` Whattheyprefertobecalled` (#` (#  Procedure: Whatwasdone?StaplesorSutures?Drainsandtheir  p location;Localinjectionpersurgeon,Unusualpositioningintraop Output:0 ` TotalemptiedbyOR,in&outcath?@"` (#` (#  Allergies:SpecialOrders(notroutine)i.e.: breathingproblems,aerosol, `"& ЀXRaysinPACU. PreOpLevelofconsciousnessandmood: oriented,sleepy, $ ) confused,scared,calm,etc. PhysicalLimitations: Hardofhearing,limbweakness,speech '`", 0  slurred,poorvision.Theseitemsareespeciallyimportantforcarotidandneuropatients. (#(#  SkinIntegrity: Preoprashes,scratches,bruises,cuts,or 0*%0 0  reddenedareas. (#(#  ForInfants: Dotheytake/orcantheyhaveabottle?All ,'3 childrenonstretchersneedbumperpads.Someadultswouldbenefitfromthem,too. .h)5 ЇWhenand ORnurse relievesonacase,thissamereportshouldbe  0  givento "Passiton." x(#(#  OtherHelpfulInformation: Weappreciateyourreportandhelp.Sinceasafetransitionfor   thepatientisourgoal,pleaseunderstandifwedon'tlookatyouwhileassessingairway,attachingmonitors,andcheckingpatient,wearelisteningtoyou(unlessastethoscopeisinourears)! ̄ Ifapatient'sairwayiscompromisedandPACUistryingto    Ѐmanageairway,theORnursecanhelpbyattachingmonitoringπequipment. Whenweallhavepatientsandsomeoneisnotimmediately (  Ѐavailabletoacceptyoupatient,pleasechooseastation,startπO2,andapplymonitors.We'llbethereASAP. SincePACUtimeisexpensiveforthepatient,wetrytokeep 0  Ѐthestaytoaminimum.Pleasekeeptheconversation "focused"  H  Ѐonthepatient.Don'tthinkwe'rerudeifwedon't"socialize"πwithyouatthistime. AtthetimeofPACUadmission,pleaserememberthatweneedto P Ѐhaveaccesstothepatientandpertinentinformationquicklysoπwhereyoustandorsitisimportant.@{ WATAUGAMEDICALCENTER p @OPERATINGROOM Theorientationexperienceisdependentoncaseavailability.  Theorientationprocesscentersonprovidingbasicknowledgeonwhichtheprecepteecanbuilduponandapplytofuturecases.@| | t Basisgoalsofyourorientationare: 8 1.0  Tolearnaseptictechnique.x!(#(#  2.0  Tolearnsafetyprecautionsforpersonnelandpatient,i.e.,  X# universalprecautions,burnprevention,nervedamage,etc. (#(#  3.0  Toidentifylegalimplicationsoftheperioperative `"& experience. (#(#  4.0  Tolearnlocationandoperationofequipmentandsterile $ ) supplies. (#(#  5.0  Tolearnlocationofappropriatereferencematerialsand '`", resourcepersonnel. (#(#  6. 0  Toidentifytheneedsofthevariedpopulationservede.g., h)$/ pediatricpatients,geriatricpatients. (#(#  7. 0  Tolearnmethodsofassistingingathering CQI information.+'2(#(#  8.0  Toreadandunderstand O.R. policiesandprocedures.P-(4(#(# Л .h)5  9. 0  Toacceptthatorientationcannotteachyoueverything.The  orientationisabroadandvariedlearningexperiencethatdependsonyoutointegrateandapplytheinformation. (#(# Followingtheformalorientationprocess,weexpectyoutocontinueseekingandinitiatinglearningexperiences,i.e.,requestunfamiliarprocedures.Yourformalorientationexperienceisconcludedwhenyouareassignedtocall.X@@@{ WATAUGAMEDICALCENTER 8 @OPERATINGROOM@hhNAMEOFTEAMMEMBERS DirectorofNursing,SurgicalServices:  p ChargeNurse:ClinicalNurseSpecialist:̢CSRSupervisor:!Staff:! OR/RN  #@( 0   %% LPN0  # # %% CST0  '`",%%  PACU/RN ChargeNurse: " *H&1 "# #"Staff"# #":"$ ,'3 OutPatientDepartment .h)5  $%ADON:  Staff:%$ $& @ 0 ` & &  @  &SonyaKellyPatPekarekEvelynTempleton0*%0%% 0  MarionYoungMaryCritcher& @ & @  Workroom/Housekeeping 󀀀    ORSecretary  ( x  AnesthesiaDeptCRNA      Anesthesiologist  (   Xray0   %% X@{ WATAUGAMEDICALCENTER 8 @OPERATINGROOM'' .h)5 @<<|DISASTERMANUALTEST̀1.0  Describeyouractionsduringahospital"CodeOrange"drill.X(#(# ̀2.0  Howwouldyourespondtoabombthreat?(#(# ̀3.0  Whenhelpingwithabombthreatsearch,youcannotturnon ( x anyswitches,butmustuseaflashlight.TorF (#(# ̀4.0  Whatdoes"CodeOne"announce?  (#(# ̀5.0  Duringa"CodeOne"youmaybecalledathometoreturnto `  theOR,evenwhennotoncall.TorF (#(# ̀6.0  Duringa"CodeOne"thatistheresultofamasscasualty, h  theORcontinueswithelectivecases.TorF (#(# ̀7.0  Duringatelephoneoutage,thebeepersystemcontinuesto  work.TorF.Iffalse,howwouldoncallstaffbenotifiedandwhatshouldyourresponsebe? (#(# ̀8.0  Whatdoes"CodeGrey"signify?0(#(# ̀9.0  WhatistheexpectedresponseintheOR?p(#(# 10.0  A"Code500"announcesa򀀀򀀀.P(#(# 11.0  Ifthe"Code500"isnotintheOR,whatisyourresponse? (#(# (( .h)5 @{ WATAUGAMEDICALCENTER  @OPERATINGROOM@|DISASTERTESTANSWERS̀1.0  Listenforlocations,closealldoors,checksmoke  detectors,checkforfire,ifunassigned,reporttothefrontdesk.Ifassigned,continuecase,mentallyprepareforevacuation. (#(# ̀2.0  Makenotes,keeppersontalking,calmlyandquietlynotify    anotheremployeetoactivatethefirealarmsystem,discussonlywithnursingsupervisor,hospitaladministratororhospitalpolice,remainonduty. (#(# ̀3.0  Th (#(# ̀4.0  Externaldisaster,masscasualty,naturaldisaster,stateof H  emergency. (#(# ̀5.0  TP(#(# ̀6.0  F0(#(# ̀7.0  False,amessengerwillbesenttoyourhome.Youmust p returntothehospitaluntiltelephonecommunicationsarereestablished.AfilewithmapstoallORcallteammembersismaintainedbythehospitalpolice. (#(# ̀8.0  Infant/childabduction.X(#(# ̀9.0  Haveallexitsmonitored.Thedepartmentissecured.8(#(# 10.0  Hostagesituation.x!(#(# 11.0  Continuewithscheduleasusual.Bepreparedtoevacuate.  X#(#(# )) .h)5 @{ WATAUGAMEDICALCENTER  @OPERATINGROOM@ yMALIGNANTHYPERTHERMIATEST̀1.0  򀀀isamusclerelaxantthatisaprimary ( x triggerformalignanthyperthermia. (#(# ̀2.0  MHisa򀀀state.  (#(# ̀3.0  CanMHbeanticipated?YorN(explain)򀀀 `  Ѐ.( (#(# ̀4.0  WhatdrugneedstobeimmediatelyavailabletotreatMHand h  wheredowestoreit?򀀀 0   (#(# Ѐ5.0  Isthisdrugreadytobeadministeredifneeded?򀀀(#(# ̀6.0  DuringMHcrisis,thepatientisinrespiratoryand P metabolic򀀀.h(#(# ̀7.0  򀀀򀀀areearlysymptomsofan  impendingMHcrisis. (#(# ̀8.0  Whatsuppliesarenecessaryformixingdantrolene?򀀀 P Ѐ.(#(# ̀9.0  򀀀isusedtoconfirmdiagnosisinsuspect X individuals. (#(# 10.0  Symptomsthatmaybenotedbysurgicalteamare:򀀀    (#(# 0  .@"(#(# 11.0  WMCdoesnotuseinhalationagentsthatarecapableof  $ triggeringMH.TorF (#(# 12.0  IncreasedbodytemperatureisagoodindicatorofMHcrisis. (#x' TorF (#(# 13.0  ListdrugsavailableintheMHcart:򀀀 % *  (#(# 0   (#(# 14.0  Howwillyoucoolthepatient?򀀀 (#.  (#(# 0   (#(#   .h)5 Ї@{ WATAUGAMEDICALCENTER x @OPERATINGROOM@ wMALIGNANTHYPERTHERMIAANSWERS   ̀1.0  Succinylcholine(anectine)( x(#(# ̀2.0  Hypermetabolic  (#(# ̀3.0  YES,historyofpersonal/familyanesthesiacomplicationsor H   death. (#(# ̀4.0  Dantrolene,MHcartinholdingarea. (#(# ̀5.0  NO,mustbemixed.0 (#(# ̀6.0  Acidosis(#(# ̀7.0  Jawrigidity,increaseinendtidalCO2.P(#(# ̀8.0  SterileH20,dispensingsyringeor60ccsyringe.0(#(# ̀9.0  Skeletalmusclebiopsytestp(#(# 10.0  Mottlingofskin,palpablewarmthofviscera,feverP(#(# 11.0  F(halothane,enflurane,isoflurane)(#(# 12.0  Foftenoccursafterothersigns p(#(# 13.0  Dantrium,SodiumBicarbonate,SoluCortef,Furosemide,   ТProcainamide,Mannitol (#(# 14.0  Hypothermiapad,ice(2W),coldNSIV,gastric,wound,  X# rectallavagewithcoldsaline. (#(#  * .h)5 Ї*,****,++,,@{ WATAUGAMEDICALCENTER  @OPERATINGROOM@{EMERGENCYCARDIACCARE ̀1.0  Wherearethecrashcartanddefibrillatorstored?` (#(# ̀2.0  Whataresomestaffsafetyconsiderationsduring  @ Тdefibrillation? (#(# ̀3.0  Duringcode"Blue"intheOR,whowillbethedirector?H  (#(# ̀4.0  Whowillinitiatechestcompressions?( (#(# ̀5.0  DoeshospitalcodeteamalwaysrespondtoORcodes?h (#(# ̀6.0  Howarethedefibrillatorpaddlesroutinelypositioned?H (#(# ̀7.0  Howfarapartshouldthepaddlesbeplaced?(#(# ̀8.0  Listprimarydutiesofcirculatorduringcode.h(#(# ̀9.0  Listdutiesofscrubnurseduringacode.(#(# 10.0  Whichemergencydrugscanbeadministeredviaan 8 Тendotrachealtube? (#(# 11.0  Howmuchpressureshouldbeappliedtothedefibrillator  paddles? (#(# 12.0  Whatenergysequencefordeliverymightyouexpecttouse?8(#(# 13.0  Whatarethemaximumnumberofshocksgiven?x!(#(# 14.0  Somepossiblecausesofasystoleintraoperativelyor  X# immediatelypostopare򀀀and򀀀. $(#(# 15.0  Doyouevercountershockatlessthan200joules?`"&(#(# 16.0  Ifdefibrillatingapatientwithatransvenouspacemakerare #@( thereanyspecialprecautions? (#(# 17.0  Whatdetermineswhethersynchronizedorasynchronized H&!+ Тcountershockisused? (#(# 18.0  Whatspecialdosageconsiderationsaremadeinthepregnant (#. patient? (#(# -- .h)5 @{ WATAUGAMEDICALCENTER  @OPERATINGROOM@ wEMERGENCYCARDIACCAREANSWERS X  ̀1.0  PACU` (#(# ̀2.0  Dryhands,dryfloor,"standclearorder" @(#(# ̀3.0  Anesthesiologist  (#(# ̀4.0  Surgeon,ifpresent` (#(# ̀5.0  NO (#(# ̀6.0  Oneelectrodejusttotherightofuppersternumbelow 0  clavicle,theotherisleftofcardiacapex(leftofnipplealongmidaxillaryline) (#(# ̀7.0  Morethan2"P(#(# ̀8.0  a.recordtime/startelapsedtimeclock0(#(# 0  b.notifyORdesk (#(# 0  c.helprepositionpatientifnecessary (#(# 0  d.obtaincrashcartanddefibrillator (#(# 0  e.assistanesthesiaproviderasnecessary (#(# 0  f.maintainaccuratecounts (#(# 0  g.document (#(# ̀9.0  a.remainsterile,keepmayoandbacktablesterile p(#(# 0  b.preparespongestopackwound (#(# 0  c.keeptrackofsponges,sharpsandinstruments (#(# 0  d.assistsurgeonasnecessary (#(# 10.0  Lidocaine,epinephrineandatropine X#(#(# 11.0  Firmpressure,about25lbs.!%(#(# 12.0  VF200j200300j,360jfollowedby360j(#x'(#(# 13.0  Nomaximumnumber,determinedbyresponse$ )(#(# 14.0  Hypoxia,hypothermiaH&!+(#(# 15.0  Yes,atrialflutter,atrialfibrillation,internalpaddles'(#-(#(# 16.0  Placepaddlesatleast5"fromgeneratorh)$/(#(# 17.0  Whetherpatienthasapulse,is"synchronized"whenpatient *H&1 hasapulse. (#(# 18.0  NONEP-(4(#(#  .h)5 Ї@{ WATAUGAMEDICALCENTER  @OPERATINGROOM@,,~FIRESAFETYTEST̀1.0  Whatisthetelephonenumberforreportingafire?(#(# ̀2.0  ListsomecausesofORfires:( x(#(# ̀3.0  WhatsituationintheORcausesfirestorapidlyescalate?  (#(# ̀4.0  WhatisRACE?H  (#(# ̀5.0  WheredomostORfiresoccur?( (#(# ̀6.0  IfyouareinvolvedinanORfire,wherewouldyoutake h  evacuatedpatients? (#(# ̀7.0  Describeactionsafter"CodeOrange"isactivated.(#(# ̀8.0  Ifyouareunassignedatthetimeofafiredrill,you P should򀀀.h(#(# ̀9.0  Ifcauteryinstrumentworks,abreakornickininsulation  isinsignificant.TorF (#(# 10.0  Thecirculatorshouldtakewhatstepstopreventafireona P patient. (#(# 11.0  Thescrubnurseshouldtakewhatstepstopreventafireon X thepatient. (#(# 12.0  Allfiberopticlightcablesprovideacoolsourceoflight,   youneednotbeconcernedifplacedondrapes.TorF (#(# 13.0  IfyouhaveasmallfireintheORthatyouquicklycontrol,  X# (1)doyoustillneedtoreportit,(2)cantheroombecleanedasusual? (#(# 14.0  ThewoundmustbeclosedbeforeevacuatingtheORand (#x' patientextubated.TorF (#(# 15.0  Toevacuate,apatientmustbemovedontoastretcher.% *(#(# 0  TorF (#(# 16.0  Whenthemainpowerswitchonthepanelisturnedoff,will '(#- theroombewithoutanyelectricity? (#(# 17.0  Primaryevacuationusuallyoccurs򀀀. 0*%0(#(#  .h)5 /V X   @{ WATAUGAMEDICALCENTER x @OPERATINGROOM@LLzFIRESAFETYTESTANSWERS   ̀ 1.0  4400` (#(# ̀2.0  Lasers,ESU,argonbeamcoagulator,faultyelectrical  @ equipment,extensioncords. (#(# ̀3.0  O2enrichedatmosphereH  (#(# ̀4.0  Rescueandremove,alarm,contain,extinguish( (#(# ̀5.0  Onthepatienth (#(# ̀6.0  AnotherOR,(possibly7&8),PACU,CC,OP,IMCU,OB,ER,2WH (#(# ̀7.0  Circulatorgoesintohalltohearlocations,notifythe  team,searchimmediateareaforsignsoffire,closealldoors,mentallyprepareforpossibleevacuation. (#(# ̀8.0  Reporttothefrontdesk(#(# ̀9.0  F8(#(# 10.0  Groundingpadplacement,avoidpoolingofprepmaterials.(#(# 11.0  ESUinholsters,listenforsoundofactivationofunused X ESUorShawscalpel. (#(# 12.0  F (#(# 13.0  (1)Yes(2)No@"(#(# 14.0  F $(#(# 15.0  F`"&(#(# 16.0  No,havelightsonly#@((#(# 17.0  Laterally% *(#(# .. p0+8 @{ WATAUGAMEDICALCENTER   @\ \ x SURGICALPROCEDURECHECKLIST x *` dddd dd  (#(#`,` dd ,8dd ,8dd ,8dd ,8dd ,8dd +   X XqXX X}2XXq  l @vvh,DISCUSSED@@:8,/DEMO  $t @  dSECOND@@]GdSCRUB  $t @FIRST@SCRUB  $t  @""CIRCULATE@AFTER@  HELP  ,  @ZZ !CIRCULATE@  !ALONE  $t @=` TYPE  ( x   ( x   ( x   ( x   ( x   ( x 1.ABDOMINAL  t    t    t    t    t    t  0 l Appendectomy  l l                      ! 0 l Herniorrhaphy  \ "l l     \ #    \ $    \ %    \ &    \ ' 0 l BowelResection X (l l    X )   X *   X +   X ,   X - 0 l LaparoscopicGB  .l l     /    0    1    2    3 0 l HiatalHernia @ 4l l    @ 5   @ 6   @ 7   @ 8   @ 9   <:   <;   <<   <=   <>   <? 2.GENERALSURGERY  @   A   B   C   D   E 0 l BreastBiopsy $Fl l    $G   $H   $I   $J   $K 0 l RadicalMastectomy  pLl l     pM    pN    pO    pP    pQ 0 l Thyroidectomy lRl l    lS   lT   lU   lV   lW 0 l Hemorrhoidectomy Xl l    Y   Z   [   \   ]   T^   T_   T`   Ta   Tb   Tc 3.OB/GYN  Pd   Pe   Pf   Pg   Ph   Pi 0 l D&C jl l    k   l   m   n   o 0 l TAH 8pl l    8q   8r   8s   8t   8u 0 l TVH 4 vl l    4 w   4 x   4 y   4 z   4 { 0 l A&PRepair !|l l    !}   !~   !   !   ! 0 l CSection "l l    "   "   "   "   " 0 l Laparoscopy $hl l    $h   $h   $h   $h   $h 0 l Hysteroscopy d% l l    d%    d%    d%    d%    d%    &"   &"   &"   &"   &"   &" 4.CARDIOVASCULAR  'L#   'L#   'L#   'L#   'L#   'L# 0 l Endarterectomy H)$l l    H)$   H)$   H)$   H)$   H)$ 0 l Embolectomy *%l l    *%   *%   *%   *%   *% 0 l VascularBypass +0'l l    +0'   +0'   +0'   +0'   +0' 0 l VeinLigation ,-|(l l    ,-|(   ,-|(   ,-|(   ,-|(   ,-|( 0 l Pacemaker x.)l l    x.)   x.)   x.)   x.)   x.)   /+   /+   /+   /+   /+   /+ @=` TYPE  d @vvh,DISCUSSED@FFj,DEMO   @""dSECOND@ZZdSCRUB   @FIRST@SCRUB   @""CIRCULATE@AFTER@  HELP    @ZZ !CIRCULATE@  !ALONE    5.THORACIC                         0 l Thoracotomy  ll l     l    l    l    l    l 0 l Mediastinoscopy h l l    h    h    h    h    h              !    "    #    $ 6.EYE   P%    P&    P'    P(    P)    P* 0 l ECCE/PHACO L +l l    L ,   L -   L .   L /   L 0    1    2    3    4    5    6 7.ORTHOPEDIC  4 7   4 8   4 9   4 :   4 ;   4 < 0 l Arthroscopy(knee,shoulder,ankle) 8>l l    0 ?   0 @   0 A   0 B   0 C 0 l LumbarLaminectomy 4Dl l    4E   4F   4G   4H   4I 0 l HipPinning Jl l    K   L   M   N   O 0 l Compression Pl l    Q   R   S   T   U 0 l HipProsthesis hVl l    hW   hX   hY   hZ   h[ 0 l ORIFAnkle d\l l    d]   d^   d_   d`   da 0 l TKR bl l    c   d   e   f   g 0 l THR Lhl l    Li   Lj   Lk   Ll   Lm 0 l BoneCementMixing Hnl l    Ho   Hp   Hq   Hr   Hs   t   u   v   w   x   y 8.ORALSURGERY  0z   0{   0|   0}   0~   0 0 l MandibularϢOsteotomy !4l l    ,!|   ,!|   ,!|   ,!|   ,!| 0 l ORIFMandible 0#l l    0#   0#   0#   0#   0# 0 l DonorBoneReconstitution 4% l l    |$   |$   |$   |$   |$   &!   &!   &!   &!   &!   &! 9.GENITOURINARY  '#   '#   '#   '#   '#   '# 0 l Prostatectomy l l  0 l 0 l l Radical   0 l 0 l l    0 l 0 l l Turp 0&$+H' dd 0  )h$   )h$   )h$   )h$   )h$   *h%   |*%   |*%   |*%   |*%   |*%   |+&   +0'   +0'   +0'   +0'   +0' 0 l TURB D-(l l    D-(   D-(   D-(   D-(   D-( 0 l Cystoscopy .)l l    .)   .)   .)   .)   .) 0 l Ureteroscopy /,+l l    /,+   /,+   /,+   /,+   /,+ @=` TYPE  d @vvh,DISCUSSED@FFj,DEMO   @""dSECOND@ZZdSCRUB   @FIRST@SCRUB   @""CIRCULATE@AFTER@  HELP    @ZZ !CIRCULATE@  !ALONE    10.ENDOSCOPIC                         0 l Bronchoscopy  ll l     l    l    l    l    l 0 l Laryngoscopy h l l    h    h    h    h    h  0 l EGD2   (esophagogastroduodenoscopy) l  l l     !    "    #    $    % 20 l Colonoscopy d &l l    d '   d (   d )   d *   d +    ,    -    .    /    0    1 11.ENT  L 2   L 3   L 4   L 5   L 6   L 7 0 l NasalReconstruction H 8l l    H 9   H :   H ;   H <   H = 0 l TympanostomyTube  >l l     ?    @    A    B    C 0 l T&A 0Dl l    0E   0F   0G   0H   0I 0 l Tympanoplasty ,|Jl l    ,|K   ,|L   ,|M   ,|N  ,|O I   .$*s XOYXP@NN| EQUIPMENTCHECKLIST  X XqX2* dJd` dd 8dd 8dd 8dd 8dd 8dd (#(#,dd ,dd ,dd +     TYPEOFEQUIPMENT  t  LOCATE/ t DEMONSTRATEDISCUSSEDDATE/INITIALS  P  ACTUAL t PATIENTUSEDATE/INITIALS  \  2XXqAIRINSTRUMENTS            ТALCONUNIT             ТARTHROSCOPYCARTX2  `    `    `  ТAUTOSUTURE   L     L     L  ТAUTOTRANSFUSIONSETUP            BLOODSCALES  ,    ,    ,  CASTCART  p    p    p  CHANGINGN2,O2,CO2TANKS  \   \    \! CODECART  "   #   $ COMPUTER  <%   <&   <' ТCONSTAVAC  ((   ()   (* ТCRICOTHYROTOMYCANNULA  l+   l,   l- ТDEFIBRILLATOR  .   /   0 DENTALCART  L1   L2   L3 DENTALSUCTION/DRILLCART  84   85   86 DENTALXRAY  |7   |8   |9 DERMATOME  :   ;   < ТDVTHOSE  \=   \>   \? ТELECTROCAUTERY/ARGONBEAM  H@   HA   HB EYEMAGNET  C   D   E FRACTURETABLE(STANDARDANDϢINTERMEDULLARYSETUPS  !G   (!H   (!I HANDTABLES  # J   # K   # L HEADLIGHTS  `$"M   `$"N   `$"O KTHERMIAUNIT,BAIRHUGGER  %L#P   %L#Q   %L#R ТLAPAROSCOPICGBEQUIPMENT  &$S   &$T   &$U LASER  ,(%V   ,(%W   ,(%X ТLAVHCART  p)'Y   p)'Z   p)'[ MALIGNANTHYPERTHERMIACART  *\(\   *\(]   *\(^ ТMESHGRAFT  +)_   +)`   +)a MICROSCOPES  <-*b   <-*c   <-*d  XqX2TYPEOFEQUIPMENT  d  LOCATE/ d DEMONSTRATE DISCUSSEDDATE/INITIALS  @  ACTUAL d PATIENTUSEDATE/INITIALS  L 2XXqMONITORSEKG,OXIMETER,BP               ORTables(Shampaine,AMSCO,Radiop,ϢUroview)       d    d  OVERHEADLIGHTS  X    X    X  PACEMAKERANALYZER   D     D     D  PATIENTSTRETCHERS            PEDIATRICCART  $    $    $  POSITIONINGAIDS:  h    h    h  ЀAIRPLANEARMREST  T   T    T! ЀBLUECHESTPILLOW  "   #   $ ЀBUTTBOARD  4%   4&   4' ЀDONUT/FOAMHEADREST  x (   x )   x * ЀPILLOWS,BLANKETS,EGGCRATE,πSHEEPSKIN  l,   d-   d. ЀSANDBAG  X/   X0   X1 ЀSHOULDERBRACES  2   3   4 ЀSTIRRUPSHANGING,ALLENCRUTCH  85   86   87 ЀVACPAC  |$8   |$9   |$: SHAWSCAPEL  h;   h<   h= ТSTRYKERSURGILAV  >   ?   @ SUCTIOND&C  HA   HB   HC SUCTIONSETUPS   4D    4E    4F TOURNIQUETS(AIR,ELECTRIC)  !xG   !xH   !xI WOLFEMACHINE  # J   # K   # L ТXOMEDPOWERDRILL  X$"M   X$"N   X$"O   %D#P   %D#Q   %D#R   &$S   &$T   &$U   $(%V   $(%W   $(%X   h)'Y   h)'Z   h)'[   *T(\   *T(]   *T(^   +)_   +)`   +)a   4-*b   4-*c  4-*d =  *Reportmalfunctionsandremovefromroom.  <0-g OY X   XqX2@PP{ WATAUGAMEDICALCENTER ` @JJOPERATINGROOMDATE:򀀀 < @ kPerioperativeOrientationActivityRecordScrubNurse@WeekI I.0  Objective:Developanunderstandingoftheoverallenvironmentofthe   Ѐperioperativearea. (#(# ̀0  LearningActivities:t (#(# 0  1.Shadowthepreceptor (#(# 0  2.Observetheoverallphysicalstructure,layoutandtrafficpatternoftheOR. 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̢Preceptee'sSignature:򀀀 'T"% 66 <0+/ @PP{ WATAUGAMEDICALCENTER  @JJOPERATINGROOM@SEEKANDFINDI  򀀀0 ` BlueRoomt ` (#` (# 򀀀0 ` Breakerboxesh ` (#` (# 򀀀0 ` CCA\ ` (#` (# 򀀀0 ` CodeBluebuttonsP ` (#` (# 򀀀0 ` CommunicationbookD  ` (#` (# 򀀀0 ` CSectionroom8 ` (#` (# 򀀀0 ` CSRdummy,| ` (#` (# 򀀀0 ` Fireextinguishersandsmokedetectors p ` (#` (# 򀀀0 ` Giftfundd ` (#` (# 򀀀0 ` HoldingareaX ` (#` (# 򀀀0 ` Intercom/roomphonesL` (#` (# 򀀀0 ` Manuals(Disaster,HazardousMaterials,Policy,Procedure,Infection @ Control) ` (#` (# 򀀀0 ` MedicineCart(` (#` (# 򀀀0 ` OPS` (#` (# 򀀀0 ` 8ORs&OB` (#` (# 򀀀0 ` Orthopaedicroom` (#` (# 򀀀0 ` PDOrequestcalendar` (#` (# 򀀀0 ` Peggy'soffice` (#` (# 򀀀0 ` Plasticcloset` (#` (# 򀀀0 ` Recoveryroom(PACU)` (#` (# 򀀀0 ` Scheduleboardandassignmentsx` (#` (# 򀀀0 ` Supplyareasl` (#` (# 򀀀0 ` Timesheet/workhours`` (#` (# 򀀀0 ` TurnoffvalveforroomsT ` (#` (# 򀀀0 ` WarmersH!` (#` (# 򀀀0 ` Workroom<"` (#` (# 򀀀0 ` Xraydummy0# ` (#` (#  /*- Ї77@PP{WATAUGAMEDICALCENTER@JJOPERATINGROOM@~SEEKANDFINDII򀀀0 ` AceBandaget ` (#` (# 򀀀0 ` BladderDrainageBagh ` (#` (# 򀀀0 ` CameronMiller\ ` (#` (# 򀀀0 ` Capsandmasks:OBP ` (#` (# 򀀀0 ` ChestBottlesD  ` (#` (# 򀀀0 ` ChestCabinet8 ` (#` (# 򀀀0 ` CystoCabinet,| ` (#` (# 򀀀0 ` CystoIrrigationTubing p ` (#` (# 򀀀0 ` ElectricalCordsd ` (#` (# 򀀀0 ` FormalinContainerX ` (#` (# 򀀀0 ` 16FrFoleyL` (#` (# 򀀀0 ` GroundingPad(stock)@` (#` (# 򀀀0 ` GYNCabinet4` (#` (# 򀀀0 ` Kittners(peanuts)(` (#` (# 򀀀0 ` LabGBMonitor` (#` (# 򀀀0 ` LAVHcart` (#` (# 򀀀0 ` Lightgloves` (#` (# 򀀀0 ` MagneticPad` (#` (# 򀀀0 ` NeedleCountPad` (#` (# 򀀀0 ` Olympuslightsource` (#` (# 򀀀0 ` PacemakerCabinet` (#` (# 򀀀0 ` PenroseDrainsx` (#` (# 򀀀0 ` ProcedureCardFilesl` (#` (# 򀀀0 ` SkinGun`` (#` (# 򀀀0 ` SpecimenContainersT ` (#` (# 򀀀0 ` Suction/light0h` (#` (# H!h(#h(#  0`+. 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򀀀0  EthiconapplicatorH " 򀀀0  FingerKwires!`# 򀀀0  FlexibleBiopsyforceps!($ 򀀀0  Frencheyeneedles"% 򀀀0  22Fr2way30cccatheterh#& 򀀀0  Gelfilm0$' 򀀀0  GlueBowl$H ( 򀀀0  .038Guidewire%!) 򀀀0  Hyskon&!* 򀀀0  IDband/sheetnewbornP'"+ 򀀀0  Infantwarmer(h#, 򀀀0  Kpad/kthermiaunit(0$- 򀀀0  Lactatedringers)$. 򀀀0  Leveeninflatorsyringep*%/ 򀀀0  LegstrapforFoley8+&0 򀀀0  Malecot/mushroomcatheters,P'1 ̀0 p Microoscillatorpowersource 4p(#p(# 򀀀0 p NailpolishremoverpadsP 5p(#p(# 򀀀0 p N/GTubeh 6p(#p(# 򀀀0 p OBbulbsyringe0 7p(#p(# 򀀀0 p OBlinencloset 8p(#p(# 򀀀0 p OpenGBinstrumentsp 9p(#p(# 򀀀0 p Owenssilk8 :p(#p(# 򀀀0 p PediactricsuctioncathP;p(#p(# 򀀀0 p PlacentaScales<p(#p(# 򀀀0 p Plastic/metaleyeshields=p(#p(# 򀀀0 p Red/Lavendertoptubesforcord X> blood p(#p(# 򀀀0 p Refrigeratorforcordblood8@p(#p(# 򀀀0 p RigidSigmoidoscopytrayAp(#p(# 򀀀0 p ScarletRedxBp(#p(# 򀀀0 p Segurabasket@Cp(#p(# 򀀀0 p ShawscalpelXDp(#p(# 򀀀0 p Silastictubing/connector Ep(#p(# 򀀀0 p SterileKwire/steinmannpinsFp(#p(# 򀀀0 p Steriletaperjaw`Gp(#p(# 򀀀0 p Storageareaforpreppads(xHp(#p(# 򀀀0 p Surgicel@Ip(#p(# 򀀀0 p Tinkletester(3/4dilator)Jp(#p(# 򀀀0 p TLSdrainKp(#p(# 򀀀0 p TMJcameraH Lp(#p(# 򀀀0 p Toomey!`Mp(#p(# 򀀀0 p Totalkneepack!(Np(#p(# 򀀀0 p Ttubes"Op(#p(# 򀀀0 p TURdrapeh#Pp(#p(# 򀀀0 p UreteralCathadapter0$Qp(#p(# 򀀀0 p Vicegrippliers$H Rp(#p(# 򀀀0 p V.Muellerdilators%!Sp(#p(# 򀀀0 p Warmercabinet/OB&!Tp(#p(# 򀀀0 p WavykneeholderP'"Up(#p(# 򀀀0 p 3waystopcock(h#Vp(#p(# 򀀀0 p Weckapplicator(0$Wp(#p(# 򀀀0 p Wetfieldcautery)$Xp(#p(# 򀀀0 p Wiredriverp*%Yp(#p(# 򀀀0 p Xeroformgauze8+&Zp(#p(# 򀀀0 p Yconnector,P'[p(#p(#   X.)^  /(+^ Ї p  /(+   (X(@66{ WATAUGAMEDICALCENTER @ @OPERATINGROOM@SEEKANDFINDV(X(#(#(򀀀0  Airstrip ( 򀀀0  ALARM  򀀀0  Albuminh  򀀀0  Ambubag0  򀀀0  Armsling H  򀀀0  Autosuture  򀀀0  Avitene  򀀀0  BananabladeP  򀀀0  Bananacuffh  򀀀0  Batteries0  򀀀0  Beanbag  򀀀0  Bloodinfusionsetp 򀀀0  Catheterintroducer8 򀀀0  100ccbagsofsalineP 򀀀0  Cerclagewireset 򀀀0  CerebellumRectractor 򀀀0  ConstavacdrainX 򀀀0  Cushingforceps p 򀀀0  Dopplerprobe8 򀀀0  DVTpressureboots 򀀀0  EEAsizersx 򀀀0  Emergencyhysterectomyset@ 򀀀0  EndotrachealtubeX 򀀀0  Envelopeforarthroscopepictures  򀀀0  EnvelopeforBJ'spictures 򀀀0  Ethrane` 򀀀0  Fogartycatheters(x 򀀀0  Gastrostomytube@  򀀀0  GluePedal ! 򀀀0  Handtables(2)!" 򀀀0  IVlidocaineH"# 򀀀0  IVpressurebag#`$ 򀀀0  JacksonPrattdrain#(% 򀀀0  Lambottes$& 򀀀0  Laminectomyropeh% ' 򀀀0  Leadintroducer0&!( 򀀀0  LinvatecInterferencescrow&H") 򀀀0  Microscopelightbulbs'#* 򀀀0  Microoscillatorsaw(#+ 򀀀0  NasalCannulaP)$, 򀀀0  NerveStimulator*h%- 򀀀0  Nonsterilestockinet*0&. 򀀀0  OBdressingroom+&/ 򀀀0  Orthoglasssplintandscissorsp,'0 򀀀0  Oscillatorblade8-(1 򀀀0  Plasmanate/hespan.P)2 򀀀0  Positionerilomed.*3 򀀀0  Replacementlightbulbs/*4  X0+5   򀀀0 p Ethrane  p(#p(# 򀀀0 p Sterileduckbill h p(#p(# 򀀀0 p Sterilelowmanretractor 0 p(#p(# 򀀀0 p Strykerirrigationunit  H p(#p(# 򀀀0 p Sumpdrain  p(#p(# 򀀀0 p Suprapubictube  p(#p(# 򀀀0 p Thrombin P p(#p(# 򀀀0 p Tibialbolt&webbh p(#p(# 򀀀0 p Tracrium 0 p(#p(# 򀀀0 p Umbilicaltape  p(#p(# 򀀀0 p Vasculargrafts p p(#p(# 򀀀0 p Vesselloops 8 p(#p(# 򀀀0 p Vesselpaws P p(#p(# 򀀀0 p Xrayfromorthopaedicoffice  p(#p(#   (X(@66{ WATAUGAMEDICALCENTER 8 @OPERATINGROOM@~SEEKANDFINDVI(X(#(#(򀀀0  Autovactransfuser p 򀀀0  BallTipGuideWireZMS 8 򀀀0  Bassettkneesplint  򀀀0  Calgiswabsx  򀀀0  Cerclagereplacementwire@   򀀀0  CholedochoscopeX  򀀀0  Coban  򀀀0  Cricothyrotomycannula  򀀀0  Dacron`  򀀀0  Deepgelpi(x  򀀀0  Dentalxrayunit@  򀀀0  Dixonbladeretractor 򀀀0  EBIexternalfixator 򀀀0  ECTreplacementscrewsH 򀀀0  Endoloop` 򀀀0  Epistatcatheters( 򀀀0  Eyemagnet 򀀀0  Eyemagnet/powersourceh 򀀀0  Fingercage/tubegauze0 򀀀0  FlexiblereamersZMSH 򀀀0  Flexibleureteroscope 򀀀0  Gelatincapsules 򀀀0  GillbiopsybrushP 򀀀0  Interceedh 򀀀0  Intermedicscrewdriver0 򀀀0  Kneeimmobilizer 򀀀0  Laserp 򀀀0  LinvatecAwl8  򀀀0  Liversuture P! 򀀀0  Magnafxsystem " 򀀀0  Maltzrasps!# 򀀀0  MiddleearimplantsX"$ 򀀀0  Mitek #p% 򀀀0  Moleskin#8& 򀀀0  Nikonlens$ ' 򀀀0  Orthoburrrustringremoverx% ( 򀀀0  Pacemakermagnet@&!) 򀀀0  Paper&inkreplacementarthroscopy 'X"* printer  򀀀0  Prostatectomysounds(#, 򀀀0  Prosthesis,radialhead,greattoe, `)$- Swansonfinger  򀀀0  Pulloutwire*@&/ 򀀀0  Ringextractor+'0 򀀀0  Rushrodtray,'1 򀀀0  SingleJureteraldiversionstentH-(2 򀀀0  Sitemachine.`)3 򀀀0  6"18gspinalneedle.(*4 򀀀0  S.S.wire/*5 򀀀0 p Steinmannpincutter p5p(#p(# 򀀀0 p Sterilebuttons 86p(#p(# 򀀀0 p 2ticron 7p(#p(# 򀀀0 p Trephinebladesx 8p(#p(# 򀀀0 p Versafxsystem@ 9p(#p(# 򀀀0 p XraytunnelX :p(#p(#  0M     (X( @  XqX ^@PP{ WATAUGAMEDICALCENTER X @ xCOMPETENCYBASEDORIENTATION@JJOPERATINGROOM̀I.0  Demonstratesknowledgeofcleaning,sterilization/disinfectionand  ( packagingasaRNorLPNinSurgicalServicesatWataugaMedicalCenter. (#(# XX:!33,33,33,33,33X%X%:2XXq*XXXX*@cPERFORMANCE@@ d@@ d@@ d@@ d    CRITERIA l  @ M LEARNINGOPTIONS    @EVALUATION@@@@zMETHODS l  @/TEACHING@@A0@@0METHOD/DATE l  @ s"EVALUATION@U U s"DATE/INITIALS l  F 26XXXXXX6A.Demonstratesability ,  tocleanandorganizeinstrumentsandequipmentforwrapping.   Preceptor ,  Preceptor ,   ,   ,  B.Useofinstrumentcardfile.  Preceptor 8 Preceptor 8  8  8 C.Abilitytocorrectlypackagesuppliesforsterilization.̀1.Knowledgeoftypesπofwraps.̀a.Musliǹb.KimberlyπClark̀c.PeelPacks̀d.Bemiscases̀e.Monarchπcases p Preceptor,EPN,B&K   Preceptor,CompleteϢEPN,SelfTests X       Ѐ2.Selectmodeofsterilization/disinfectionofinstrumentsandequipmentwithproperoperationofthatmode.̀a.Steamautoclavèb.SteradSterilizer̀c.Cidex̀d.Ionizingradiation !$ ТEPN/B&K $ CompleteEPNSelfTest $  $  D% Ѐ3.Selectmonitoringmethodforsterilization.̀a.Graphs̀b.Biologicalindicator̀c.Indicatorstrips̀d.Indicatortape %!* ТEPN/B&K "*  "*  "*  "* Ѐ4.Checkpackageintegrityandshelflife,ifapplicable,priortouse. <(#, Preceptor 'T",  'T",  'T",  'T", Ѐ5.Knowledgeofhandlingandstorageofsterileitems. *%. Preceptor t)$.  t)$.  t)$.  t)$. D.CareoftheOR̀1.Cleaningafterroutinecases.̀2.Roomsetupaftercleaning.̀3.Restockingrooms/specialassignments. /*4 Preceptor̢EPN/B&K -l(6 PreceptorCompleteEPNSelfTests -l(8  +4'8  +4'8 X- hX   XqX FԀ                    :33,33,33,33,33XoXo:@ pII.PerformsBasicSkillsoftheScrubNurse  :!33,33,33,33,33X%X%:F XXq@OOcPERFORMANCE@@- d@@- d h  CRITERIA  T @  M LEARNINGOPTIONS h  @}EVALUATIONMETHODS h  @ss/TEACHINGMETHOD/@@}0@@}0@@}0DATE  T @ s"EVALUATION@ s"DATE/INITIALS  T A.DonORattireaccordingtopolicy.  ( B&K̢EPN  ( Preceptor,CompleteϢEPNSelfTests  (  <   <  B.Scrubaccordingtopolicyandprocedure.   Preceptor `  Preceptor `   `   `  C.Createsterilefield.̀1.Gownandgloveself̀2.Gownandgloveotherscrubteammember̀3.Changegownand/orgloveduringcasè4.Setupsteriletablè5.Setupmayostand̀6.Drapeorassistindraping̀7.Removegownandgloveatcasecompletion  Preceptor̢EPNB&K (x CompleteEPNSelfTests 4   4   4  D.Implementpracticesforthepreventionofinfection.̀1.Recognizeandreportbreaksinaseptictechniqueinselfandothers̀2.Takecorrectiveactiontoremedycontaminationerrors̀3.Inserturinarycatheter̀4.Demonstrateknowledgeofdistinctionbetween"clean"&"sterile"̀5.Confinecontaminationtoareaaroundsterilefield̀6.Minimizetalking&noiselevelinroom̀7.Recognizelimitationsofsterileareasoǹa.gowǹb.tablèc.operativefield  '\"4 Preceptor̢EPN l5 PreceptorCompleteEPNSelfTest l6   6   6 E.CareofSpecialityPatientPopulations̀1.Pediatric̀2.Pregnant̀3.Elderlỳ4.Latexsensitive P+&; B&K,POLB&K,POL,ARTB&K,POL,ARTPOL,ART P+&@ CompletionofSelfLearningModulesCompletionofSelfLearningModules P+&E  D(#E  D(#E :33,33,33,33,33XoXo: ,'E  h1,M P. h   :!33,33,33,33,33X%X%:@cPerformanceCriteriaF.DemonstrateKnowledgeof:̀1.Passingsurgicalinstrumentsinfunctionalpositioǹa.Clamps&graspinginstruments̀b.Sutures̀c.Blades&Scissors̀d.Retractors P  @ M LearningOptionsPreceptor < @}}}EvaluationMethodsPreceptor < @ss/TeachingMethod/Date  @s"EvaluationDate/Initials  Ѐ2.Suturèa.Typè1.absorbablè2.nonabsorbablèb.Sutureneedles̀1.Shapè2.Point̀3.EyeofNeedle 4  B&K̢EPN (  CompletesEPNSelfTests  $     Ѐ   3.Surgicaldrains&catheters̀4.Surgicaldressings̀5.Countsponges,sharps,&instrumentsaccordingtohospitalpolicỳ6.Methodtodecreasetheoperativetimeoftheptby:̀a.UsingMDprefcards̀b.Practingunfamiliarskills̀c.Anticipatingneedsoftheteam̀d.Usingproperresourcepersonnel7.OSHAStandards̀a.radiologicalπhazards̀b.chemicalhazards8.FDAreporting9.ESUuse&safety10.Bloodtransport11.Usesafepracticewithtissuesandspecimenswithinthesterilefield.12.PropercontainmentanddisposalofallϢsharpesandhazardousmaterials.13.Properhandlingofmedicationinsterilefield. $$"< B&K,EPNPolPreceptorOSHA,MAN,B&K̢EPN,STAN̢EPN,STANPOLPOLPOLPOL "!\ CompleteEPNSelfTestsPreceptor b  lb  lb G.Demonstrateabilitytofunctionduringurgent&emergencysituations̀1.ImplementSTATordersappropriatelỳ2.Location&useoffireϢextingishers,cutoffswitchesforelectricity,ϢO2,N20(forOR&PACU),Firepullboxes,emergencyexits,evacuationroutes ,*m PreceptorARTPOLMAN )8(t CompleteSelfLearningModule )'z  \%#z  \%#z @cPerformanceCriterià3.Knowledgeofpreoperativepredictorsof 1$0 malignanthyperthermia,locationofcart,systemfordilutingDantrium 8 @ M LearningOptionsARTPOL 1$0   h @}}}EvaluationMethodsCompleteSelfLearningModule 1$0  h   H-+ @ss/TeachingMethod/Date h   .- @s"EvaluationDate/Initials7%  7 h 4.Knowledgeofresponsetoairembolism̀5.KnowledgeofORresponsetoCodeGrey,Code500,bombthreat,andCodeOne  ARTMANPOL H  PreceptorSelfLearningmodule D   p   p   t+ *F  t+ *  t+ *  t+ *  ,D+,  -|,,  -|,,  -|,,  -|,,  -|,, :33,33,33,33,33XoXo:XqX F8 /-,  1/. 8@PP{WATAUGAMEDICALCENTER@~ ~ yOPERATINGROOMORIENTATION@,,dIII.DEMONSTRATESKNOWLEDGEOFBASICSKILLSOFTHECIRCULATINGNURSEF XXq:!33,33,33,33,33X%X%:@cPerformanceCriteria l @ M LearningOptions l @}}}EvaluationMethods l @ss/TeachingMethod/Date l @s"EvaluationDate/Initials l A.Performspreoperativepreparationofroom&equipmentbasedonpatient&surgicalneedsby:̀1.Dampdustallhorizontalsurfacesincludinglights̀2.Acquireappropriatesupplies&equipmentforprocedurè3.Implementpracticestopreventinfection:̀a.Opensterileitemswithoutcontaminatioǹb.Poursolutionscorrectlỳc.Tiegownofscrubteammembers̀d.Placefurniturewithinsterilefield̀e.Monitorself&othersin&outofsterilefield̀f.Reportbreaksinaseptictechniquèg.Takecorrectiveactiontoremedycontaminationerrors̀h.Preppatientaccordingtopolicy&physicianpreferencèi.Inserturinarycatheterwithoutcontamination.̀j.Minimizeflowoftrafficin&outofroom̀k.Minimizetalking&noiselevel ) Preceptor,B&KPOL,B&K E Preceptor  E   E   E B.Performspreoperativepatientassessment&transfertoOR.̀1.IDpatientby:̀a.Havingpt.statename,doctor,surgicalprocedure&operativesite.̀b.CheckingIDband&comparingname&numberwithchart&nameplate.̀2.Confirmwithpt.&chart:̀a.Surgicalconsent̀b.Allergies,dentures,contactlenses,jewelry,hearingaid̀c.H&P̀d.Labs&xraysasordered +)Z Preceptor̢EPNSTAN (('k PreceptorCompleteEPNSelfTest '&{  4{  4{ @cPerformanceCriteria  .,~ @ U LearningOptions p-, @}}}EvaluationMethods p-, TeachingMethod/Date  ., EvaluationDate/Initials  ., Ѐe.Availabilityofblood/consentforblood̀f.Coughing&deepbreathingdiscussed 1/ Ѐg.Physicallimitations/prosthesis̀3.Transferpt.fromholdingtoORbed̀a.Maintainpt.privacy p POL D/-  h  D/-  h  D/-  h  D/-  h C.IntraoperativephaseProvideforpt'ssafetỳa.Securesafetystrap̀b.Padheels&elbows̀c.Insurevisualsurveillanceofpt.atalltimes̀d.Groundpt.forϢelectrosurgicalsafetỳe.Countsponges,sharps,&instruments̀f.Standatpt'ssideduringinductiontoassist&provideprotectioǹg.Takeappropriateactionwhencountsareincorrect̀h.Preparemedicationscorrectlỳ2.Positionpt.topromote:̀a.Circulatoryhomeostasis̀b.Respiratoryhomeostasis̀c.Neuromuscularhomeostasis̀d.PatientPrivacỳe.Exposureforoperativeprocedurèf.Administrationofanesthesià3.Pagesurgeonandanesthesiaatappropriatetimè4.Positionpt.inthefollowingpositionswithorwithouttheuseofpositioningaids:̀a.Supinèb.Pronèc.Lithotomỳd.JackKnifèe.Lateral̀f.Semilateral̀g.Sitting̀h.Semifowler̀i.ENT̀j.Fracturetablèk.Trendelenburg/orreverseTrendelenburg̀l.Kneechest \%#5 PreceptorPOLB&K̢EPNPOLPOL̢EPN,B&K̢EPN,B&K Y PreceptorCompleteSelfLearningModuleCompleteSelfLearningModuleCompleteEPNSelfTestCompleteSelfLearningModuleCompleteEPNSelfTest 8      &,%  &,%  &,%  &,%  &,%  *p)  'd&  'd&  'd&  'd& @cPerformanceCriteria ,* @ M LearningOptions ,* @}}}EvaluationMethods ,* @ss/TeachingMethod/Date ,* @s"EvaluationDate/Initials ,* Ѐ5.Preparesurgicalsite:̀a.Removehairasindicated̀b.Utilizeprepsolutionsperphysicianpreferencè1.Expose&prepcorrectarea(s)̀2.Preventpoolingof 1$0 solution'sunderpt.̀3.Maintainproperbodyalignmentduringprep̀6.Handleblood&tissuespecimensby:̀a.Labelingspecimencorrectlỳb.Selectappropriatecontainerforspecimens̀c.Followprocedureforhandlingspecimens̀1.Transportofspecimensforfrozensections(FS)̀2.Routinespecimenwithformaliǹ3.Cultures̀4.Amputatioǹ5.Bronchialwashings̀6.ABG̀7.Cordblood̀8.CordpH̀9.Placenta&cord10.Lympnodesd.Documentationofdepositionofspecimens7.Assistwithdecreasingtheoperativetimeby:̀a.Usingphysicians'preferencecards̀b.Practicingunfamiliarskills̀c.Anticipatingneedsoftheteam̀d.Sendingpromptlyforsubsequentpt.̀e.Usingresourcepersonnel̀f.Informingappropriateindividualsofchangesinpatient'scondition8.Assistwithdressing/cast/splint/slingatendofprocedure9.Completesdocumentationappropriatelyon:̀a.Intraoperativerecord̀b.Countsheets̀c.Chargesheets̀1.supplies̀2.sutures̀d.Narcoticrecord̀e.Pathologysheet̀f.Unusualoccurrencesheet # "8  1$0? ЇPOL,PreceptorPreceptorPreceptorPreceptorPreceptor,POL p.  1$05 ЇPreceptorPreceptorPreceptorPreceptorPreceptor  /  H-+/  h  H-+  h  $X#  $X#  $X#  $X#  $X#  %$  %$  %$  %$  %$  0'%  0'%  0'%  0'%  0'% @cPerformanceCriteria )' @ M LearningOptions h(' @}}}EvaluationMethods h(' @ss/TeachingMethod/Date h(' @s"EvaluationDate/Initials h(' 10.Demonstratecosteffectivenessbỳa.Completingcharges̀b.Usingsuppliesjudiciously11.Classifywounds12.ParticipateasteammemberD.PostoperativePhase:̀1.Removeintraoperativeequipment 1$0  Ѐ2.TransportpatienttoPACUorPt.Careunitandgivereport̀3.ReturnunusedϢsuppplies̀4.Placespecimens,Ϣxrays,preferencecards,etc.inproperlocations̀5.Clean&stockroomforfollowingprocedures.   PreceptorPreceptorPreceptor /P.  h PreceptorPreceptor /P.   h  <*(  h  <*(  h :33,33,33,33,33XoXo:^  F@$$REFERENCEKEY P Title     `     h      p Key   ̢Atheison,L.Berry&Kohn'sOperatingRoomTechnique  B&K   Spry,C.EssentialsofPerioperativeNursing     p EPN  p  OSHAHandbook `     h     OSHA  8  DisasterManual `     h     MAN h  ТMSDSManual   `     h     MAN 0  AORNStandardsandRecommendedPractices    STAN   WMCPolicy&Procedure    h     POL X  ArticleFile   `     h     ART         1/5 Ї@66{ WATAUGAMEDICALCENTER  @OPERATINGROOM@@INSTRUMENTSETS̢ACMICystoscope̢ACMIMicroUreteroscope̢ACMIResectoscope(New)̢ACMIResectoscope(Old)̢ACMI/CirconResectoscope̢ActabulargaugesetAdenoidset̢AnspachFixationSystem̢Arthroscopicextra̢Arthroscopicinstrumenttray̢BankhartshoulderrepairkitBreastBiopsytrayBronchoscopeandaccessoriesCardiovascularTrayCarpalTunnelTray̢CerclageWireSystemColonResection/HiatalHerniaTrayCommonDuctExplorationInstrumentCompressionHip/KnowlesPinInstCompressionHip/VersaFixCone/LeepsetCornealTransplantInstCRTTrayCutdownset̢CystoextrasD&CTrayHanks/Hagar̢DCRTrayDentalRestorationsInstrumentDentalRetractorSetDistalTargetingdevice(IMNail)Dr.Flemming'sHandTrayDr.Freeman'sLaparoscopicInstTrayEarMiscellaneous̢EBIWristFixatorECTInstrumentSetECTMiniFragmentSetEmergencyThoroscopyInstEndoscopicSinusTray̢Esophagoscope(Rigid)andDilatorsExternalEyeTrayI&IIExtractionSetEyeTraumaTrayFacialPlasticSetGITrayHeadandNeckSet̢HemorrhoidectomyTrayHerbertBoneScrewsHernia/AppendectomyTray̢HiatalHerniaExtras̢HSCset(Hysteroscopy)̢InsituTrayInterlockingNailgeneralInstwithRetractors̢IntraconeIntramedullaryReamerSystem(IMNail)̢IntraocularTrayI&IIKneeArthrotomyset 1/= ЇPage2(cont.d)̢LAVHTray̢LambotteOsteotomes̢Laminectomy̢LaminectomyExtras̢Laparoscopiccholecystectomytray̢Laparoscopiccholecystectomyextras̢LithotripsyPercutaneousInst̢LinvatecACLsetMajorsetwithretractorsMajorwithoutMagnaFixTrayMastectomyTray̢MediastinoscopyTrayMicroHandTrayMiddleearBasicSetModularAustinMooreTraysx3̢MonotubeExternalFixationsystemNasalInstNasalExtrasOlympusCystoscopeOlympusResectoscopeOpenGallbladderOralSupplementSetPlasticSetPediatricSinusSetPediatricSinuscopesPostPartumTubaltray̢RectractorTrayRotatorCuffRepairTrayRushRodTrayShoulderTray̢ShuttMasterSetSinglepuncturescopeSitesystemSkeeterEarDrillSofttissuesetStapesSetStapleSet̢StorzCystoscopeforLithopoxy̢StorzUreteroscope̢Synthessetandscrews̢SynthessmallfragmentsetT&Ainst̢TAHextras̢TAHTray(TotalAbdominalHysterectomy)TearDuctProbeSetThompson/EndoprosthesissetThoracicExtrasThoracicTraysI&IITotalHipGeneralInst̢THR(TotalHipTrays)ThyroidExtrasTotalKneeGeneralInst̢TKR(TotalKneeTrays)̢TMJextrasTotalHipGeneralInstTotalKneeGeneralInstTracheotomytrayTrauma/AneurysmTrayTrauma/OsteotomySet 1/= ЇPage3(cont.d)̢TVHTray(TotalVaginalHysterectomy)TympanicTubessetUrologyTrayI&IIVisualUrethrotomeWolfLaparoscopicTray̢ZMSFemorial/TibialInst