Transcript Orientation to Surgical Technology & History of Surgery

Orientation to Surgical
Technology & History of
Surgery
ST210
Concorde Career College
History
Objectives:
• Provide a timeline of events leading up to
modern medical/surgical practice
• Understand the development of the role of the
surgical technologist
• List and describe reasons for surgical
intervention
History
Refer to Table 1-1 Pages 4-5 (ST4ST)
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Ancient Times
Dark Ages
Renaissance
Classical Period
Modern Age
Ancient Times
4,000 BC
Cuneiform Script
Ancient Times
• Imhotep
▫ Circa 2,500 BC
▫ Considered the first physician
of recorded history
▫ Wrote one of the first surgical
texts
▫ Considered divine due to his
work
Ancient Times
• Code of Hammurabi
• Contains contractual laws and
medical practices of the day
• Many medical references are
religious in nature
Code printed on clay tablet
Ancient Times
• Moses
▫ Circa 2000 BC
▫ Established laws for
cleanliness
• Caduceus
▫ Numbers 21:4-9
Ancient Times
• Circa 1500
▫ Ebers Papyrus
▫ Egyptian Medical hieroglyphs
▫ Hindu Vedas
Ancient Times
• Circa 1,000 BC
▫ Homer
 Early Greek historian and
mythologist
 Described military medicine
▫ Susruta
 Father of Indian medicine
Classical Period (500 BC – 500 AD)
• Hippocrates
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460 – 370 BC
Greek physician
The Father of Medicine
Introduced the concept that
illness has a physical and
rational explaination
Classical Period
• Aristotle
▫ 384 – 322 BC
▫ Established early scientific
mindset
▫ Founder of comparative
anatomy
Classical Period
• Herophilos
▫ 335 – 380 BC
▫ Father of Anatomy
▫ First to describe the pulse as
a diagnostic tool/vital sign
Classical Period
• Aulus Cornelius Celsus
▫ 25 BC – 50AD
▫ Greek Encyclopaedist
▫ First to describe the cardinal
signs of inflammation
Classical Period
• Aelius Galen
▫ 129 – 200AD
▫ World’s first great anatomist
▫ Observations remained
unchallenged for over 1,500
years
▫ Believed that science was
ruled by theology and
adapted writings to reflect
this viewpoint
Dark Ages (500 AD – 1100 AD)
Dark Ages
• Avicenna
▫ 980 – 1037 AD
▫ Persian philosopher
▫ Wrote The Canon of
Medicine
▫ Revived Aristotle’s theories
Renaissance (1450 – 1600)
• Paracelsus
▫ 1493 – 1541 AD
▫ Swiss physician
▫ Disagreed with Galen and
Avicenna, but could not prove
his theories scientifically
▫ Called the Luther of Medicine
Renaissance
• Ambroise Pare
▫ 1510 – 1590 AD
▫ French barber surgeon
▫ Greatest surgeon of the 16th
century
▫ Began ligating arteries after
amputation
▫ Stopped cauterizing wounds
with hot irons and oils
Renaissance
• Andreas Vesalius
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1514 – 1564
Flemish anatomist
Father of Modern Anatomy
Openly challenged Galen
Performed dissections on
human cadavers himself
▫ Hired famous illustrators to
depict his anatomic findings
▫ Changed the world’s
approach to anatomic
discovery
Vesalius
Renaissance
• William Harvey
▫ 1578 – 1657
▫ First to accurately describe
circulatory anatomy and
physiology
Modern Age
• Morgagni
▫ Developed modern-day
clinical pathology
• Edward Jenner
▫ 1749 – 1843 AD
▫ Credited with discovering the
small pox vaccine
▫ Father of Immunology
▫ His work has saved more
lives than any other man
Modern Age
• Louis Pasteur
▫ 1822 – 1895 AD
▫ French chemist and
microbiologist
▫ Father of Microbiology
Modern Age
• Joseph Lister
▫ 1827 – 1912 AD
▫ Father of Asepsis
▫ Used carbolic acid to cleanse
wounds and sterilize surgical
instruments
Modern Age
• William S. Halsted
▫ 1852 – 1922
▫ Developed techniques for
meticulous wound closure
▫ Halsted’s Principles of Tissue
Handling
▫ Developed sterile surgical
gloves
Modern Age
• Michael E. DeBakey
▫ 1908 – 2008 AD
▫ Developed the first
ventricular assistive pump
device
▫ Invented critical components
of the heart-lung machine
▫ Inventions and discoveries
made cardiac surgery
possible
▫ Developed and patented
numerous surgical
instruments
Modern Age
• Denton Cooley
▫ Born 1920
▫ Perfected the heart-lung
machine
▫ Performed first US heart
transplant
▫ Implanted first total artificial
heart
What differences do you see?
History
Once these three principles were identified and
solutions found – modern medicine could
emerge!
1.
Infection
2. Pain
3. Hemorrhage
History
Development of the Role of the Surgical
Technologist
• How/why did the profession originate?
• How has surgical technology education evolved?
• Why are you here?
History
Reasons for Surgical Intervention
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Trauma
Disease
Condition
Congenital Anomaly
Desire
History
Classifications of Surgical Intervention
• Emergent – Immediate threat to life or limb (requires
immediate treatment)
• Urgent – Urgent threat to life or limb (requires
treatment within a short period of time)
• Elective – Does not have to be performed within a short
period of time (may be scheduled in the future)
• Optional – Not pathological in the traditional sense (not
necessary)
History
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Surgical Specialties
General Surgery (General)
Obstetric and Gynecologic Surgery (OB/GYN)
Ophthalmic Surgery (Eye)
Otorhinolaryngologic Surgery (ORL/ENT)
Oral and Maxillofacial Surgery (OMF)
Plastic and Reconstructive Surgery (Plastic)
Genitourinary Surgery (GU)
Orthopedic Surgery (Ortho)
Cardiothoracic Surgery (Hearts/Chest)
Peripheral Vascular Surgery (PV)
Neurosurgery (Neuro)
Workplace Management
• CAAHEP: Commission on the Accreditation of Allied
Health Education Programs
• ARC/STSA: Accreditation Review Council on Education
in Surgical Technology and Surgical Assisting
• NBSTSA: National Board of Surgical Technology and
Surgical Assisting
• JC: Joint Commission, formerly known as the Joint
Commission Accreditation of Health Care Organizations
(JCAHO)
Phases of Surgical Care Management
• Preoperative: prior to initiation of the surgical
procedure
• Intraoperative: while procedure is being
performed
• Postoperative: when surgical procedure is
terminated
PREOPERATIVE CASE MANAGEMENT
PPE
OR Preparation
Sterile field (creating, organizing,
maintaining)
Organizing
Assisting with gowning and gloving
Draping
INTRAOPERATIVE CASE
MANAGEMENT
Maintain the sterile field
Handling of instruments, supplies, etc.
Preparing medications
Counting
Proper specimen identification and labeling
Dressing application
POSTOPERATIVE CASE
MANAGEMENT
Maintain the sterile field until the patient is
out of the room
Disassemble the sterile field
Patient transportation
Room turnover
Surgical Team Members
NON-STERILE SURGICAL TEAM
MEMBERS
Circulator (RN,
LPN, or Surgical
Technologist)
Anesthesia
Provider
Radiology
Technologist
Pathology
Surgical Observers
Anyone outside of
the sterile field
CIRCULATING DUTIES
Preparing the OR
Conducting pre-op patient interview
Transporting to and from the OR (Pre-op, PACU)
Transporting the pt. to and from the OR table
Positioning
Prepping the skin
Assist with draping
Assist anesthesia
Counting, gathering supplies
Various cord hook-ups
Maintaining the OR record
Specimens
Dressings
Non-sterile Team Members
ANESTHESIA PROVIDER
RESPONSIBILITIES
MD, DO, CRNA
Pt. assessment
Determining type of
anesthesia
Discussing the risks of
anesthesia
Monitoring vital signs
Providing supportive
measures (airway,
fluids)
STERILE TEAM MEMBERS
WHO ARE THEY?
Surgical Technologist
Surgeon
MD, DO, DPM, DDS, DMD
Surgical Assistant
CSFA, CSA, SA-C, CRNFA or RNFA, PA-C, OT-C
or OPA-C, surgical resident, or other surgeon
CST (limited scope)
The Surgeon
• Assumes full
responsibility
for all medical
acts of
judgment and
management of
the surgical
patient
Surgical First Assistant
 Manual dexterity
and physical
stamina are
required
 Acts as co-surgeon
 Responsible for
exposure and
visualization of the
wound
Why Surgical Technologists?
Personal Characteristics
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Ability to multi-task
Neat, accurate
Ability to stay focused in any situation
Stable temperament, patience
Manual dexterity, physical stamina
Ability to anticipate “what comes next”
Working Conditions
• Brightly lit, quiet, temperature controlled
OR
• Standing for long periods of time
• Lifting heavy objects
• Concentration
• Unpleasant sites, odors, hazardous
materials, communicable diseases
• 40 hour work-week plus “call rotation”
nights, holidays, and weekends