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.
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 unison and harmony to create a superb outcome. The operating room (OR) team does the same thing. They coordinate their work with each other to have a successful operation.
Patients undergoing surgery will be taken care of the operating room team. Safety and privacy of patients in the OR is safeguarded by the operating room team members. Personnel inside the OR consist of the operating surgeon, assistants to the surgeon, a scrub person, an anesthesiologist and a circulating nurse. Each member of the OR team performs specific function in coordination with one another to create an atmosphere that best benefit the patient.
The team is divided into two divisions according to the function of its members.
- Sterile OR team: operating surgeon, assistants to the surgeon and scrub person
- Unsterile OR team: anesthesiologist or nurse anesthetist, circulator and other OR members that might be needed in operating specialized machine or devices.
Classification of OR team
There are two types of OR team according to the functions of its members.
- Sterile team members
- Assistants to the surgeon
- Scrub person (either a registered nurse or surgical technologist)
- Unsterile team members
- Biomedical technicians, radiology technicians or other staff that might be needed to set up and operate specialized equipment or devices essential in monitoring the patient during a surgical operation
Sterile Operating Room Team
The members of the OR sterile team will do the following things:
- Perform surgical hand washing (arms are included).
- Don sterile gowns and gloves.
- Enter the sterile field.
- Handles sterile items only.
- Functions only within a limited area (sterile field).
- Wear mask.
The surgeon is a licensed physician (MD), osteopath (DO), oral surgeon (DDS or DMD), or podiatrist (DPM). This professional is especially trained and is qualified by knowledge and experience for the performance of a surgical operation.
Responsibilities of a surgeon:
- Preoperative diagnosis and care of the patient
- Performance of the surgical procedure
- Postoperative management of care
Assistants to surgeon
During a surgical procedure, the operating surgeon can have one or two assistants to perform specific tasks under his/her (operating surgeon) direction. The responsibilities of a surgeon’s assistant:
- Help maintain the visibility of the surgical site
- Control bleeding
- Close wounds
- Apply dressings
- Handles tissues
- Uses instruments
Types of Assistants to Surgeon:
- First Assistants could either be:
- A qualified surgeon or resident in an accredited surgical education program. The first assistant should be capable of assuming the operating surgeon’s responsibility in cases of incapacitation or accidents.
- Registered Nurse and surgical technologists that have a written hospital policy permitting the action.
- Second Assistant could be a registered nurse or surgical technologist. These staff should be trained and they mar retract tissues and suction body fluids to help provide exposure of the surgical site.
A scrub person could be the following:
- Registered Nurse
- Surgical technologist
- Licensed practical/vocational nurse
The responsibility of a scrub person is to maintain the integrity, safety and efficiency of the sterile field throughout the surgical procedure.
Unsterile Operating Room Team
The unsterile operating room members are not allowed to enter the sterile field to prevent contamination. The responsibilities of the members of this team are the following:
- Handle supplies and equipments that are considered unsterile.
- Touches unsterile surfaces only.
- Keep the sterile team supplied with supplies handled aseptically.
- Give direct patient care.
- Assist the sterile team member’s need with strict observation of avoiding contact to the sterile field.
- Handles other requirements arising during the surgical procedure.
Anesthesiologist or Anesthetist
Difference between an anesthesiologist and anesthetist
An anesthesiologist is a medical practitioner who is certified by a certain institution while an anesthetist could either be a qualified and licensed nurse, dentist or a physician who administers anesthetics. The anesthetist works under the supervision of an anesthesiologist or a surgeon when administering a drug or gas.
Responsibilities of an anesthesiologist or anesthetist
- Choice and application of appropriate agents.
- Choice and application of suitable techniques of administration.
- Monitoring of physiologic function.
- Maintenance of fluid and electrolyte balance.
- Blood replacement.
- Helps in minimizing the hazards of shock, fire and electrocution.
- Use and interpret correctly a wide variety of monitoring devices.
- Overseeing the positioning and movement of patients.
- Oversee the postanesthesia care unit (PACU) to provide resuscitative care until the patient has regained vital functions.
A circulator is preferably a registered nurse. However, in some cases a surgical technologist can perform the role of a circulator with the direct supervision from a registered nurse.
Responsibilities of a circulator:
- Monitor and coordinate all activities within the room.
- Manage the care required for each patient.
- Provides assistance to any member of the OR team with strict observation to avoid a break in sterility.
- Creates and maintains a safe and comfortable environment for the patient through the implementation of aseptic technique.