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History of Operating Room

-. History of Operating Room. Before the Operating Room: The early surgeons were either priests, magicians, physicians or barber-tradesmen who understood anatomy and were comfortable with the common practices of amputation and trephination. Trephination.

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History of Operating Room

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  1. - History of Operating Room

  2. Before the Operating Room: The early surgeons were either priests, magicians, physicians or barber-tradesmen who understood anatomy and were comfortable with the common practices of amputation and trephination

  3. Trephination • is perhaps the oldest of surgeries that we know. • The practice was probably originally performed for spiritual and magical reasons, and was performed by kings, priests and magician-physicians. • The Law Code of Hammurabi (1700 BC) called for a surgeon’s hand to be cut off if the life of a person of high social order was lost as

  4. The Egyptian physician-surgeons became specialists, some concentrating on the head, others eyes, yet others on the abdomen. They had extensive knowledge of anatomy. • Egyptian surgical instruments were some of the most sophisticated to be found until well after the Middle Ages. • Indian physicians were thus confronted with a large number of patients with a problem. They learned the detailed anatomy and the surgical techniques that would lead to the development of both ENT (ear nose and throat) surgery and plastic surgery

  5. In china :The first use of anesthesia for surgical procedures, using a combination of wine and a form of cannabis • In Greece: The first surgical training program was applied • In Rome: The birth of the operating tent

  6. In Islamic Medicine: • The first surgical suites has been built. • Abu Baker al-Razi was the first person to introduce the use of alcohol for medical purposes. and also, was an expert surgeon and the first to use opium for anesthesia.

  7. Related medical and surgical termsAccording to WHO Health is • " A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity." • Optimal Health: • " Is the best an individual can feel and function in the particular circumstances." • Disease: • " Is the failure of the adaptive mechanism to stresses, resulting in disturbance in function or structure of any organ or system of the body."

  8. Illness: • " State of discomfort that results when disease, deterioration, or injury impairs person’s health" • Surgical intervention: • " Is a therapeutic process to maintain health." • Surgery: • "Is a branch of medicine that encompasses preoperational preparation, intra operative management and postoperative care of pt.

  9. Surgery as a branch of medicine deals with operative procedure for: • Correction of deformities and defects. • Repair of injuries. • Diagnosis and cure of disease process. • Relief of suffering and prolongation of life.

  10. Surgical technology • The number of operations performed increase that is related to: • Increased number of population. • Increased incidence of trauma and congenital deformities. • Increasing number of aged persons with degenerative disease. • Rapid progress of medical fields

  11. Purposes of Surgery: • To preserve life • e.g. Relief of intestinal obstruction or decompression of skull fracture.(#) • To maintain dynamic body equilibrium • e.g. Removal of diseased kidney. • To undergo diagnostic procedures • e.g. Breast biopsy, bronchoscopy, gastroscopy. • To prevent infection and promote healing • e.g. Burn debridement. • To obtain comfort and to ensure the ability of living. • Curative • Cosmetic surgery, which reconstructs the skin and underlying structures

  12. The types of operations performed in a hospital vary according to the expertise of surgeons and staff, the community in which the facility is located and equipment available.

  13. Types of surgery: • Surgical procedures are commonly grouped according to: • A. Purpose • DiagnosticConfirms or establishes a diagnosis, Example : biopsy of a mass in a breast. • PalliativeRelieves or reduces pain or symptoms of a disease, it does not cure, Example : resection of nerve roots. • ConstructiveRestores appearance that has been lost or reduced, Example : breast implant • TransplantReplaces malfunctioning structures; Example : hip replacement

  14. Degree of Urgency • Emergency SurgeryIs performed immediately to preserve function or the life of the client. Example : surgeries to control internal hemorrhage • Elective SurgeryIs performed when surgical intervention is the preferred treatment for a condition that is not imminently life threatening (but may ultimately threaten life or well being) or to improve the client’s life. Example : cholecystectomy for chronic gallbladder disease, plastic surgery procedures such as breast reduction surgery

  15. Degree of Risk • Major SurgeryIt involves a high degree of risk, for a variety of reasons: It may be complicated or prolonged, large losses of blood may occur, vital organs may be involved, or postoperative complications may be likely. Example : organ transplant, open heart surgery, removal of kidney • Minor SurgeryIt involves little risk, produces few complications, and is often performed in a “day surgery”. Example : breast biopsy, removal of tonsils, knee surgery.

  16. Phases of surgical care: • preoperative phase: • Extends to the time the pt. moved onto the operating table. • Intraoperative phrase: • Begins at this time and ends when the pt. admitted to the recovery room. • postoperative phrase: • Continued from the immediate recovery period to complete rehabilitation. • The safety and welfare of pts. are ensured to the nurse from the moment of arrival in the operation room until departure (leaving) and transfer of the responsibility to another professional health care member.

  17. Surgical technologist (ST): Is the person who works in the operating room with surgeons, anesthesiologist, anesthetist and professional registered nurse as a member of direct care team during surgical intervention. • Operating room experience techs that no operation is minor Every operative procedure carries high risk. Safe procedure can rapidly become a catastrophic – pt. could be allergic to the medication, to anesthesia, uncontrolled bleeding, irreversible shock, sudden Cardiac arrest on operating table

  18. Surgical preference card • There is a card for each surgery and for each surgeon in this card there is: • The name of the instrument he likes and use. • The types of suture he likes. • The surgical position for each operation. • The cards are placed in a drawer in OR supervisor's office • Benefits of these cards: • keep work going smoothly. • Keep the surgeon comfortable during his work

  19. Legal issues in operating system • Team: • "Is a group of two or more who recognize the common goals and doing their effort to achieve it." • Health care team: • "All personal relating to the pt. those in direct pt. contacts as well as those who contact with the pt. indirectly". • The team common goal: • "Is relieving of suffering restoration of bodily structure and function and favorable post op outcome. • Operating Room Team (personal): • When a patient is about to undergo a surgical procedure direct patient care will be pass on to the operating room personnel. The operating room OR team is responsible for the well-being of a patient throughout the operation. • This team should not only consider the patient’s privacy but will also promote safety measures for the patient. One way of promoting safety of patients inside the OR is by preventing infection from the surgical incision that will be done.

  20. As described, the OR team is similar to that of a symphony orchestra. There are many members in an orchestra but they work together in union and harmony to create an interesting outcome. • The operating room team does the same thing. They coordinate their work with each other to have a successful operation.

  21. Expected behavior of ORnursing personal: • Empathic: • These persons have Intuitive awareness of what the patient is experiencing (feeling similarly like the pt.). • Conscientious • These persons will not compromise or sacrifice principles of self – accountability. • Efficient and well - organized: • Persons who develop organized work habits know that pts. are properly prepared • Flexible and adaptable: • OR team members react quickly to changing in a calm manner. • Understanding, Reassuring and Supportive: • Team members allow others to express their feelings this coveys to pts. that the team's ability to relieve physical and emotional discomfort.

  22. Skilled listener, Observer and Communicator: • These persons who listen and look will act effectively. • Considerate: • These persons respect other people's concepts. • Objective: • These persons get assemble data before making judgment and they view the situation form all sides before taking action.

  23. Readiness: • OR team are ready to their operations with the required equipment and they are prepared for the unexpected • All personal involved in caring for surgical pts. during the critical intraoperative phase must be familiar not only with policies, procedure and surgeon's routine, but also with equipment. • .

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