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Chapter 10 - Assisting with minor surgery. Minor surgical procedures are frequently performed in ambulatory care settings and office practices. As a medical assistant, you must be knowledgeable of the types of procedures performed where you are employed. In this chapter you will learn: Define the medical assistant’s role in minor surgical procedures, describe types of wounds and explain how they heal, describe special surgical procedures performed in an office setting,...
CHAPTER 10 Assisting with Minor Surgery © 2011 The McGraw-Hill Companies, Inc All rights reserved 102 Learning Outcomes 10.1 Define the medical assistant’s role in minor surgical procedures 10.2 Describe types of wounds and explain how they heal 10.3 Describe special surgical procedures performed in an office setting 10.4 List the instruments used in minor surgery and describe their functions © 2011 The McGraw-Hill Companies, Inc All rights reserved 103 Learning Outcomes (cont.) 10.5 Describe and contrast the procedures for medical and sterile asepsis in minor surgery 10.6 Describe the medical assistant’s duties in preparing to assist in minor surgery 10.7 Describe the medical assistant’s duties in preparing a patient for surgery © 2011 The McGraw-Hill Companies, Inc All rights reserved 104 Learning Outcomes (cont.) 10.8 Describe the types of local anesthetics for minor surgery and the medical assistant’s role in their administration 10.9 Describe the duties of the medical assistant as a floater and as a sterile scrub assistant 10.10 Describe the medical assistant’s duties in the postoperative period © 2011 The McGraw-Hill Companies, Inc All rights reserved 105 Introduction • Minor surgical procedures – Ambulatory care settings – Office practices • Medical assistant – Types of procedures – Patient preparation – Assisting physician during the procedure – Patient care following the procedure © 2011 The McGraw-Hill Companies, Inc All rights reserved 106 The Medical Assistant’s Role in Minor Surgery • Administrative – Completing insurance forms – Obtaining signed informed consent forms – Patient education • Explaining procedure to and answering questions from the patient Presurgical instructions â 2011 The McGraw-Hill Companies, Inc All rights reserved 107 The Medical Assistant’s Role in Minor Surgery (cont.) • Relative to surgical procedure – Prepare surgical room – Prepare equipment – Assist during procedure • Unsterile • Sterile – Ensure safety and comfort of the patient • Postoperative procedures – Patient care – Dress wound – Patient education • Wound care • Postoperative care – Clean room for next procedure © 2011 The McGraw-Hill Companies, Inc All rights reserved 108 Apply Your Knowledge What are the medical assistant’s responsibilities in relation to patient education and minor surgical procedures? ANSWER: The medical assistant may be responsible for providing patient education concerning the following: Explanation of the procedure Presurgical instructions Postoperative instructions Wound care © 2011 The McGraw-Hill Companies, Inc All rights reserved 109 Surgery in the Physician’s Office • Minor surgical procedure – Safely performed in office or clinic without general anesthesia – Use local anesthetics affecting only a particular area • Reasons – – – – Diagnose illnesses Repair an injury Removal of small growths Cosmetic © 2011 The McGraw-Hill Companies, Inc All rights reserved 1010 Common Surgical Procedures in an Office • Draining an abscess – collection of pus formed due to an infection • Mole (nevus) removal – Small discolored area of the skin – Done if the mole changes shape, size, or color • Obtaining a biopsy specimen – Removal of a small amount of tissue for examination – Specimens are placed in 10% formalin, a common preservative © 2011 The McGraw-Hill Companies, Inc All rights reserved 1033 Intraoperative Procedures (cont.) – Sterile scrub assistant • Performs a sterile scrub and wears sterile gloves • Arranges instruments according to use – – – – – – Cutting instruments Grasping instruments Retractors Probes Suture materials Needle holders and scissors • Other duties – Swab fluids from wound – Retract wound – Cut suture material © 2011 The McGraw-Hill Companies, Inc All rights reserved 1034 Apply Your Knowledge What are the duties of a floater? ANSWER: During a procedure, the floater monitors the patient, documents, processes specimens, adds items to sterile field, pours sterile solutions, assists with additional anesthetic, keeps the area clean during the procedure, repositions the patient, and adjusts lighting © 2011 The McGraw-Hill Companies, Inc All rights reserved 1035 Postoperative Procedures • Immediate patient care is the top priority – Administer medications as directed – Monitor vital signs – Watch for adverse reactions – Keep the patient lying down for the prescribed length of time – Document all observations in the patient’s chart © 2011 The McGraw-Hill Companies, Inc All rights reserved 1036 Postoperative Procedures (cont.) • Dressing the wound – Sterile material used to cover the incision – Purpose • • • • Keeps wound clean Reduces bleeding Absorbs fluid drainage Reduces discomfort to the patient • Speeds healing • Reduces the possibility of scarring – Procedure • Clean examination gloves • Clean site with povidone-iodine • Antibiotic ointment, if ordered Secure sterile dressing â 2011 The McGraw-Hill Companies, Inc All rights reserved 1037 Postoperative Procedures (cont.) • Bandaging the wound – A clean strip of gauze or elastic material – Purpose • Holds the dressing in place • May improve circulation • Provides support or reduces tension on the wound • Prevents the wound from reopening • Prevents movement of the area of the body © 2011 The McGraw-Hill Companies, Inc All rights reserved 1038 Postoperative Procedures (cont.) • Postoperative instructions – Guidelines for pain management – Instruction for wound care – Dietary restrictions – Activity restrictions – When to call the physician – Have patient repeat to verify understanding – Provide written materials in a postoperative information packet • Patient release – Follow-up appt – Transportation arrangements – Follow-up appointment © 2011 The McGraw-Hill Companies, Inc All rights reserved 1039 Postoperative Procedures (cont.) • Surgical room cleanup – Place reusable instruments in a disinfectant soak – Dispose of waste and sharps appropriately – Disinfect the counters, exam table, and trays according to OSHA guidelines – Disinfect small pieces of nonsurgical equipment © 2011 The McGraw-Hill Companies, Inc All rights reserved 1040 Postoperative Procedures (cont.) • Follow-up care – Physician examines surgical wound – The dressing is changed and/or wound closures are removed • Suture or staple removal is done to 10 days after minor surgery • Ready for removal when there is a clean, unbroken suture line • There should be no scabs, seeping, or visible opening present © 2011 The McGraw-Hill Companies, Inc All rights reserved 1041 Apply Your Knowledge What is the difference between a dressing and a bandage? ANSWER: A dressing is a sterile material used to cover the incision, whereas a bandage is a clean strip of gauze or elastic material used to hold the dressing in place Excellent! © 2011 The McGraw-Hill Companies, Inc All rights reserved 1042 In Summary 10.1 The medical assistant’s role in minor surgery includes both administrative and clinical tasks These include but are not limited to completing insurance forms, obtaining signed patient consent, preparing the surgical room, and assisting during a procedure 10.2 Wounds are defined as either surgical or accidental and include incisions, lacerations, and puncture wounds Wounds heal in three phases: inflammatory phase, proliferative phase, and maturation phase © 2011 The McGraw-Hill Companies, Inc All rights reserved 1043 In Summary (cont.) 10.3 Several special surgical procedures are performed in an office setting These include laser surgery, cryosurgery, and electrocauterization 10.4 Various categories of instruments are used in minor surgery These include instruments for cutting and dissecting, grasping and clamping, retracting, dilating, and probing, suturing, injecting, withdrawing fluids, and obtaining specimens © 2011 The McGraw-Hill Companies, Inc All rights reserved 1044 In Summary (cont.) 10.5 Medical asepsis involves reducing the number of microorganisms to prevent the spread of disease The goal of surgical asepsis is to eliminate all microorganisms 10.6 A medical assistant’s preoperative duties include providing preoperative instructions to the patient, ensuring that all necessary paperwork is completed, easing the patient’s fears, and preparing the surgical room © 2011 The McGraw-Hill Companies, Inc All rights reserved 1045 In Summary (cont.) 10.7 The medical assistant’s role in preparing the patient for surgery includes determining whether the patient has followed presurgical instructions, obtaining the patient’s vital signs, checking medication orders, gowning and positioning the patient, and preparing the patient’s skin for surgery 10.8 Local anesthetics are used during most minor surgical procedures and may be either injected or applied topically The medical assistant will prepare the anesthetic so that the physician can administer it © 2011 The McGraw-Hill Companies, Inc All rights reserved 1046 In Summary (cont.) 10.9 A medical assistant may serve in one of two capacities during a surgical procedure One is as an unsterile assistant known as a floater and the other is as a sterile scrub assistant 10.10 A medical assistant’s postoperative duties include giving immediate patient care, dressing and bandaging the wound, giving postoperative instructions, assisting with patient release, and cleaning the surgical room © 2011 The McGraw-Hill Companies, Inc All rights reserved 1047 End of Chapter 10 A wise doctor does not mutter incantations over a sore that needs the knife. ~ Sophocles © 2011 The McGraw-Hill Companies, Inc All rights reserved ... rights reserved 10 5 Introduction • Minor surgical procedures – Ambulatory care settings – Office practices • Medical assistant – Types of procedures – Patient preparation – Assisting physician... (cont.) 10. 5 Describe and contrast the procedures for medical and sterile asepsis in minor surgery 10. 6 Describe the medical assistant’s duties in preparing to assist in minor surgery 10. 7 Describe... for minor surgery and the medical assistant’s role in their administration 10. 9 Describe the duties of the medical assistant as a floater and as a sterile scrub assistant 10. 10 Describe the medical