Bài giảng Medical Assisting - Chapter 42: Assisting with Minor Surgery

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 421Objectives:42-1 Define the medical assistant's role in minor surgical procedures.42-2 Describe types of wounds and explain how they heal.42-3 Describe special surgical procedures performed in an office setting.42-4 List the instruments used in minor surgery and describe their functions.Assisting with Minor Surgery 2Objectives (cont.)42-5 Describe and contrast the procedures for medical and sterile asepsis in minor surgery.42-6 Describe the medical assistant’s duties in preparing to assist in minor surgery.42-7 Describe the medical assistant’s role in preparing a patient for surgery.Assisting with Minor Surgery 342-8 Describe the types of local anesthetics for minor surgery and the medical assistant’s role in their administration.42-9 Describe the duties of the medical assistant as a floater and as a sterile scrub assistant.42-10 Describe the medical assistant’s duties in the postoperative period.Objectives (cont.)Assisting with Minor Surgery 4Introduction Minor surgical procedures are performed in ambulatory care settings and office practicesYou must be knowledgeable of the types of procedures performed. You will need to know how to prepare the patient for surgery, assist the practitioner during surgery, and care for the patient after surgery.5Role in Minor Surgery You will perform administrative tasks prior to patient surgeryCompleting forms for insuranceObtaining signed informed consent formsExplaining all aspects of the surgical procedure to the patient6Surgery in the Physician’s OfficeProcedures that can be done safely in the office or clinic without general anesthesiaMinor surgery involves the use of a local anesthetic in the form of an injection or a cream applied to the skin Minor surgery is performed to diagnose an illness or repair an injury.7Minor Surgeries Repair of a lacerationIrrigation and cleaning of a puncture woundWound debridementRemoval of:Foreign bodiesSmall growthsNail or part of a nailCollection of a biopsy specimen8Wound HealingInitial phase – lag phase- white cells and blood components seal the wound, clot the blood, and remove bacteria and debrisProliferation phase – new tissue formsMaturation phase – involves the formation of scar tissueWhat phase of healing is seen here?Maturation phase9Special Minor Surgical ProceduresLaser Surgery – intense beam of light used to cut away tissueCryosurgery – use of extreme cold to destroy unwanted tissue Electrocauterization – needle, probe, or loop heated by electric current to destroy the target tissue10Apply Your KnowledgeAn 65-year-old female has a wound on her left calf that is healing poorly. When reviewing her chart what conditions would you look for that would indicate the reason for the poor healing?11Apply Your Knowledge -AnswerAge, poor circulation, diabetes, poor nutrition, high stress levels, weakened immune system, obesity, and smokingA 65-year-old female has a wound on her left calf that is healing poorly. When reviewing her chart, what conditions would you look for that would indicate the reason for the poor healing?12Instruments Used in Minor Surgery Cutting and Dissecting InstrumentsCan you name these?13Instruments Used in Minor Surgery (cont.) Grasping and Clamping InstrumentsCan you name these?14Instruments Used in Minor Surgery (cont.)Retracting, Dilating, and Probing InstrumentsCan you name these?15Instruments Used in Minor Surgery (cont.)Suturing InstrumentsCan you name these?16Instruments Used in Minor Surgery (cont.)Syringes and NeedlesInstrument Trays and Packs Laceration repair tray Incision and drainage trayForeign body and growth removal trayOnychectomy (nail removal) trayVasectomy traySuture and staple removal trays17AsepsisTwo types are used to maintain the safety of the patient and the health care professionalMedical asepsis (clean technique)Surgical asepsis (sterile technique)18Medical AsepsisReduces the number of microorganisms and prevents the spread of diseaseUse personal protective equipmentUse of sharps and biohazardous waste handling and disposal19Surgical AsepsisPurpose is to eliminate all microorganismsCommon procedures using sterile techniqueCreating a sterile fieldAdding sterile item to sterile fieldPerforming a surgical scrubPutting on sterile glovesSanitizing, disinfecting, and sterilizing equipment 20Apply Your KnowledgeName at least one instrument for each of the following types:Cutting and dissectingGrasping and clampingRetracting, dilating, and probingSuturing21Apply Your Knowledge -AnswerCutting and dissecting – scissors, scalpels, curettesGrasping and clamping – forceps, hemostats, clampsRetracting, dilating, and probing – retractors, dilators, probesSuturing – needle holders, needles, packaged suturesName at least one instrument for each of the following types:22Preoperative ProceduresPreliminary dutiesPreoperative instructionAdministrative and legal tasksEasing the patient’s fearsPreparing the surgical roomPreparing the PatientInitial tasksGowning and position the patientSurgical skin preparationCleaning the areaShaving the areaApplying the antiseptic23Intraoperative ProceduresPreparing the local anesthetic you will need to know:Use of topical applicationUse of injectionsPotential side effects of the anestheticUse of epinephrineMonitoring the patientProcessing specimensHandling instruments24Assisting the Physician During Surgery Serves as a floaterMonitoring and recordingProcessing specimensOther dutiesPouring sterile solutionsKeeping the surgical area clean and neat during the procedureReposition the patient as necessaryAdjusting lighting.25Assisting the Physician During Surgery (cont.)Sterile scrub assistant – you perform a sterile scrub and wear sterile glovesHandling instruments in the following order:Cutting instrumentsGrasping instrumentsRetractorsProbesSuture materialsNeedle holders and scissors26Postoperative ProceduresImmediate patient care is the top priority :Administer medications as directedMonitor vital signsWatch for adverse reactionsKeep the patient lying down for the prescribed length of timeDocument all observations in the patient’s chart27Dressing the woundSterile material used to cover the incisionServes to keep wound cleanReduces bleedingAbsorbs fluid drainageReduces discomfort to the patientSpeeds healing Reduces the possibility of scarringPostoperative Procedures (cont.)28Bandaging the woundA clean strip of gauze or elastic materialHolds the dressing in placeMay also improve circulationProvides support or reduces tension on the woundPrevents the wound from reopeningPrevents movement of the area of the body.Postoperative Procedures (cont.)29Postoperative InstructionsGuidelines for pain managementInstruction for wound careDietary restrictionActivity restrictionFollow-up appointmentProvided in writing and included in the postoperative information packet.30Postoperative Information PacketProper wound care instructionsSuggestions for pain reliefDietary restrictionsActivity restrictionTiming for follow-up appointments31Surgical Room CleanupPlace reusable instruments in a disinfectant soak that has anticoagulant propertiesPlace disposable waste in the sharps or biohazardous waste containerClean the counters, exam table, and trays according to OSHA guidelinesDisinfect small pieces of nonsurgical equipment.32Follow-Up CareYou may be asked to change the dressing or remove the wound closures.Suture or staple removal takes place 5 to 10 days after minor surgery.Suture or staples are ready to be removed when a clean, unbroken suture line is observed.No scabs, no seeping, and no visible opening should be present.33Apply Your KnowledgeWhat is the difference between a dressing and a bandage?34Apply Your Knowledge -AnswerA 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.What is the difference between a dressing and a bandage?35Summary Medical Assistant You perform many functions during the patient’s preoperative and postoperative care. At all times you must ensure the safety and comfort of the patient and be knowledgeable enough to function as the doctor’s “right hand” during the procedure.36End of ChapterEnd of Chapter37