Hello, I am Mike from Surgtech Academy
and today I’m going to demonstrate a few skills I call second skills or accessory
skills. The reason I call them second skills is because they only take a second
to complete. Today I’m going to cover loading and unloading a scalpel blade,
loading a suture for a right-handed surgeon, constructing a sponge stick, and
filling an asepto. Now, normally I would be sterile as I perform these skills. I
would be gowned and gloved etc. But today for education purposes I’m going to
demonstrate these unsterilaly. Now, a couple of things to remember with the
scalpel. That’ll be our first skill. Is that there is a ridge on the scalpel
blade. I mean we can see that ridge right there and it’s used to insert the blade.
The second thing I want you to notice is that the angle of the blade matches the
angle of the knife handle. It coincides. Now well, now a lot of hospitals are
using safety blades now which i think is great. That method is certainly safer but
this method is for those that aren’t using safety blades which for me is most
of Iowa. So using your right hand take the needle holder and grasp the blade at
the top with the sharp side facing to the left. With your left hand, position
the knife blade so that it’s angled up and that the angle matches the angle.
Carefully fit the blade into the groove and then extend or slide the blade down
following the ridge of the needle holder until you hear a click. Oh good.
So I want to show you that again. So I’m gonna grasp the blade. The sharp end is
facing to the left. Angle matches the angle I’m gonna fit the blade into the
ridge. Slowly slide it on until I hear the click. Such a great sound isn’t it?
Now I’m going to show you how to remove the blade.
So pointing the blade down, super important, I’m gonna ratchet the blade at
the end, slightly lift the blade off the knife handle, and push it away.
Perfect. Now sometimes it’s easier for students to move the knife handle upside
down because they think they use they think they see more of the blade that
way. So I’m gonna go ahead and show you that technique to. Put the blade back on.
Now from the backside, I suppose they can see a little more blade. Ratchet the
needle holder onto the knife blade, pull down, and that’s removed. And that my
friends is loading and unloading a knife handle. So our second demonstration is
going to be loading a suture for a right-handed surgeon. I think it’s
easiest to load the suture as we would in the clinical setting with the suture
still in the packet. Now some students will perform this a bunch of times and
I’ll show you how to perform that skill after we take the suture out of the
packet. So first let’s grab the needle holder.
Using our ring finger and our thumb and only loading in at the first digit we’re
gonna grasp the needle holder. Now, it’s super difficult if you bury this
instrument in your hand to maneuver it. So make sure that you only put it on the
first first knuckle. So laying the suture flat on your Mayo stand or back table.
Come down flat with your palm or sorry with your palm down and the back of your
hand up. Once you come down grab the suture, ratchet it so you hear click, and
go ahead and pull out. And that is what I would call a perfectly loaded stitch. Now
there is a way we can do this not by wasting a ton of suture. So we started
with our… on our back table. Alright. So you want to make sure that the needle
starts as a smiley face and that the suture trails off to the right. Now some
students believe that it’s easier to do the the palm up. I think it’s best to do
palm down. So again with smiley face, stitch string going to the right,
come down at about 30 degrees, one-third of the way down on the needle, ratchet.
And there we have a perfectly loaded stitch. Now I know some surgeons like
their needles at 90 degrees. Alright, some like them at 45 degrees. However
they like it go ahead and do that. I tell my students about 30 degrees. Now with
students and new people that want to practice that multiple times that’s the
way you would do that outside of the package.
Alright, next second skill is we’re going to construct a sponge stick. I’ve
seen this done a bunch of different ways and I’m going to show you two of those
ways. But first I’m going to show you the way that I think is best. So the first
method for constructing a sponge stick is the way I teach my students and the
reason I like this is because it covers the entire end of the ring forceps and I
think it provides the least chance for tissue damage. The first step is probably
the most important. You need to start your sponge in a diamond shape. Not in a
square. Fold the bottom third of the sponge up, place your sponge forceps in
the middle, and start folding the sides in. And that is a sponge stick. Now some
surg techs think the second method is way faster and tighter. But again, I’ve
never really timed it. And basically this method is you fold the sponge into
thirds, fold it in half, and then load it onto your sponge forceps that way. Now
again, I’ve never timed it, I don’t know which way is faster, but I do like the
first method better strictly because all of the metal is completely covered and
if the surgeon is one of those surgeons that really likes to dissect I like
having all the metal of the sponge forceps covered. Now our last second
skill is lower sorry filling up and an asepto. This is a skill we do every
single day. So we have our saline in our pitcher. Simply squeeze the bulb, insert
the tip into the saline, release, and lift. The key is not to splash
all over your back table or all over your circulator. Unless you’re a little
passive-aggressive and want to splash your circulator then maybe that’ll be okay.
But here at search tech Academy we don’t advocate splashing the back table or our
circulators. Now for my students to pass this second skill test out, alright,
they have to make sure that the saline is to the tip of the asepto and once
that is. That’s a perfectly loaded astepo. Now bulb syringes are done in the
same manner. You have to be a little more careful because you can’t see the saline
in the bulb syringe. But it’s still the same steps. So there you have it. All of
our second skills. Loading and unloading a scalpel blade, loading a stitch,
constructing a sponge stick, and filling up an asepto. So, please subscribe to my SurgTech Academy channel. I want you
to have a great day in surgery and remember be a superstar in your O.R.