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Chapter 41. Assisting with Minor Surgery. PowerPoint® P\presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson. Learning Outcomes. 41.1 Define the medical assistant’s role in minor surgical procedures.

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Presentation Transcript
slide1

Chapter 41

Assisting with Minor Surgery

PowerPoint® P\presentation to accompany:

Medical Assisting

Third Edition

Booth, Whicker, Wyman, Pugh, Thompson

learning outcomes
Learning Outcomes

41.1 Define the medical assistant’s role in minor surgical procedures.

41.2 Describe types of wounds and explain how they heal.

41.3 Describe special surgical procedures performed in an office setting.

41.4 List the instruments used in minor surgery and describe their functions.

41.5 Describe and contrast the procedures for medical and sterile asepsis in minor surgery.

learning outcomes cont
Learning Outcomes (cont.)

41.6 Describe the medical assistant’s duties in preparing to assist in minor surgery.

41.7 Describe the medical assistant’s duties in preparing a patient for surgery.

41.8 Describe the types of local anesthetics for minor surgery and the medical assistant’s role in their administration.

41.9 Describe the duties of the medical assistant as a floater and as a sterile scrub assistant.

41.10 Describe the medical assistant’s duties in the postoperative period.

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

Introduction
the medical assistant s role in minor surgery
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
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

The Medical Assistant’s Role in Minor Surgery(cont.)
apply your knowledge
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

Correct!

surgery in the physician s office
Surgery in the Physician’s Office
  • Minor surgical procedure
    • Safely performed in office or clinic without general anesthetic
    • Use local anesthetics affecting only a particular area
  • Reasons
    • Diagnose illnesses
    • Repair an injury
    • Removal of small growths
    • Cosmetic
surgery in the physician s office common procedures
Surgery in the Physician’s Office:Common Procedures
  • Draining an abscess – collection of pus formed due to an infection
  • Obtaining a biopsy specimen
    • Removal of a small amount of tissue for examination
    • Specimens are placed in a preservative
surgery in the physician s office common procedures cont
Caring for wounds

Accidental

Laceration – jagged, open wound

Puncture wound – deep wound caused by a sharp object

Intentional – surgical incision

Cleaning a non-surgical wound

Wash with soap and water

Irrigate with sterile solution

Debridement – removal of debris or dead tissue

Surgery in the Physician’s Office: Common Procedures (cont.)
surgery in the physician s office common procedures cont11
Surgery in the Physician’s Office: Common Procedures (cont.)
  • Wound healing
    • Inflammatory phase –
      • Vessels in area constrict – reduces bleeding
      • Platelets, clotting factors, and WBCs seal the wound, clot the blood, and remove bacteria and debris
    • Proliferation phase
      • New tissue forms, closing off wound
      • Phase can be sped up if edges of wound are approximated
    • Maturation phase – formation of scar tissue
surgery in the physician s office common procedures cont12
Surgery in the Physician’s Office: Common Procedures (cont.)
  • Closing a wound
    • Butterfly closures or sterile strips
    • Skin adhesive
    • Sutures
      • Absorbable – collagen fibers
      • Nonabsorbable – silk, nylon, polyester
    • Staples
surgery in the physician s office special procedures
Laser surgery

Intense beam of light used to cut away tissue

Does less damage to surrounding tissue

Electrocauterization

Needle, probe, or loop heated by electric current to destroy the target tissue

Requires a grounding plate or pad to prevent an electric shock

Cryosurgery

Uses extreme cold to destroy unwanted tissue

Patient education – wound care

Surgery in the Physician’s Office: Special Procedures
apply your knowledge14
Apply Your Knowledge

A 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?

  • ANSWER: Reasons for poor wound healing include:
  • Age Poor nutrition
  • Poor circulation High stress levels
  • Diabetes  Weakened immune system
  • Obesity  Smoking

Very Good!

instruments used in minor surgery
Instruments Used in Minor Surgery
  • Cutting and dissecting instruments
    • Scalpels
    • Scissors
    • Curettes
instruments used in minor surgery cont19
Syringes and needles

Inject anesthetic solutions

Withdraw fluids

Obtain biopsy specimens

Instrument trays and packs

Laceration repair tray

Incision and drainage tray

Foreign body and growth removal tray

Onychectomy (nail removal) tray

Vasectomy tray

Suture and staple removal trays

Instruments Used in Minor Surgery (cont.)
apply your knowledge20
Apply Your Knowledge

Name at least one instrument for each of the following types:

1. Cutting and dissecting

2. Grasping and clamping

3. Retracting, dilating, and probing

4. Suturing

ANSWER:

scissors, scalpels, curettes

forceps, hemostats, clamps

SUPER!

retractors, dilators, probes

needle holders, needles, packaged sutures

asepsis
Asepsis
  • Priority during surgical procedures
    • Critical to heath and safety of the patient
    • Levels
      • Medical – clean technique
      • Surgical – sterile technique
asepsis medical
Reduces the number of microorganisms and prevents the spread of disease

Handwashing

Personal protective equipment

Provides a barrier between wearer and infectious or hazardous materials

Gloves, masks, gowns

Sharps and biohazardous waste handling and disposal

Puncture and leak-resistant containers

Biohazard symbol

Asepsis: Medical
asepsis surgical
Asepsis: Surgical
  • Eliminates all microorganisms
  • Common procedures using sterile technique
    • Creating a sterile field
      • Used as a work area during procedure
      • Keep above waist level
    • Adding sterile item to sterile field
      • Outer one inch is “contaminated”
      • Instruments and supplies
      • Pouring sterile solutions
asepsis surgical cont
Asepsis: Surgical (cont.)
  • Performing a surgical scrub
    • Removes more microorganisms than handwashing
    • 2–6 minutes
  • Putting on sterile gloves
  • Sanitizing, disinfecting, and sterilizing equipment
apply your knowledge25
Apply Your Knowledge

What is the difference between medical and surgical asepsis?

ANSWER: Medical asepsis reduces the number of microorganisms present. It requires good handwashing, the use of personnel protective equipment, and proper disposal of sharps and biohazardous waste.

Surgical asepsis is the elimination of microorganisms through sanitizing, disinfection, and sterilization. Requires performing a surgical scrub and donning sterile gloves.

Fantastic!

preoperative procedures
Preoperative Procedures
  • Preliminary duties
    • Preoperative instructions
      • Procedure
      • Dietary and fluid restrictions
      • Bring someone to drive home
    • Administrative and legal tasks – signed informed consent
    • Easing the patient’s fears – education and communication
preoperative procedures cont
Preoperative Procedures (cont.)
  • Preparing the surgical room
    • Equipment and supplies
      • Check date and sterilization indicator
    • Neat, clean, and free of waste
    • Adequate lighting
preoperative procedures cont28
Preoperative Procedures (cont.)
  • Preparing the patient
    • Initial tasks
      • Vital signs
      • Medication orders
    • Gown and position the patient
    • Surgical skin preparation
      • Clean the area
      • Remove hair from the area
      • Apply the antiseptic
apply your knowledge29
Apply Your Knowledge

Mr. Smith is having a minor surgical procedure on his forearm. You notice that he has a lot of hair at the site. What should you do?

ANSWER: You should use a scissors or electric trimmer to trim the hair just prior to surgery.

Good Answer!

intraoperative procedures
Administering a local anesthetic

Topical application

Gels, creams, and sprays

Takes 10 to 15 minutes to be effective

Injections

Usually administered by the physician

Check label to verify correct medication

Potential side effects

Dizziness, loss of consciousness, seizures, or cardiac arrest

Use of epinephrine

Reduces bleeding

Prolongs action of local anesthetic

Intraoperative Procedures
intraoperative procedures cont
Intraoperative Procedures(cont.)
  • Assisting the physician during surgery
    • Floater
      • Monitoring and recording
      • Processing specimens
      • Other duties
        • Pouring sterile solutions
        • Keeping the surgical area clean and neat during the procedure
        • Repositioning the patient as necessary
        • Adjusting lighting
intraoperative procedures cont32
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

Intraoperative Procedures(cont.)
apply your knowledge33
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.

Bravo!

postoperative procedures
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
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

Postoperative Procedures(cont.)
postoperative procedures cont36
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
postoperative procedures cont37
Postoperative instructions

Guidelines for pain management

Instruction for wound care

Dietary restrictions

Activity restrictions

When to call the physician

Follow-up appointment

Have patient repeat to verify understanding

Provide written materials in a postoperative information packet

Patient release

Follow-up appt.

Transportation arrangements

Postoperative Procedures(cont.)
postoperative procedures cont38
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
postoperative procedures cont39
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 5 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
apply your knowledge40
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!

in summary
Medical assistant

Preoperative

Patient instructions

Administrative and legal tasks

Prepare the patient emotionally

Set up surgical room

Intraoperative

Floater

Surgical scrub assistant

Postoperative

Patient care

Patient instructions

Clean room

In Summary

At all times you must ensure the safety and comfort of the patient.

end of chapter
End of Chapter

End of Chapter 41

A wise doctor does not mutter incantations over a sore that needs the knife.

~ Sophocles