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PowerPoint

to accompany
Second Edition
Ramutkowski Booth Pugh Thompson Whicker
Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Medical Assisting
Chapter 42
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Objectives:
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
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Objectives (cont.)
42-5 Describe and contrast the procedures for medical
and sterile asepsis in minor surgery.
42-6 Describe the medical assistants duties in preparing
to assist in minor surgery.
42-7 Describe the medical assistants role in preparing a
patient for surgery.
Assisting with Minor Surgery
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42-8 Describe the types of local anesthetics for minor
surgery and the medical assistants 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 assistants duties in the
postoperative period.
Objectives (cont.)
Assisting with Minor Surgery
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Introduction
Minor surgical
procedures are
performed in
ambulatory care
settings and office
practices
You 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.
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Role in Minor Surgery
You will perform
administrative tasks
prior to patient surgery
Completing forms for
insurance
Obtaining signed
informed consent forms
Explaining all aspects
of the surgical
procedure to the patient

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Surgery in the Physicians Office
Procedures that can
be done safely in the
office or clinic
without general
anesthesia

Minor 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.
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Minor Surgeries
Repair of a laceration
Irrigation and cleaning of a
puncture wound
Wound debridement
Removal of:
Foreign bodies
Small growths
Nail or part of a nail
Collection of a biopsy
specimen

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Wound Healing
Initial phase lag phase-
white cells and blood
components seal the
wound, clot the blood, and
remove bacteria and debris
Proliferation phase new
tissue forms
Maturation phase
involves the formation of
scar tissue

What phase of healing is
seen here?
Maturation phase
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Special Minor Surgical
Procedures
Laser Surgery intense beam of light used
to cut away tissue
Cryosurgery use of extreme cold to destroy
unwanted tissue
Electrocauterization needle, probe, or loop
heated by electric current to destroy the target
tissue
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Apply Your Knowledge
An 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?
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Apply Your Knowledge -Answer
Age, poor circulation, diabetes, poor nutrition,
high stress levels, weakened immune system,
obesity, and smoking
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?
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Instruments Used in
Minor Surgery
Cutting and Dissecting Instruments



Can you
name these?
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Instruments Used in
Minor Surgery (cont.)
Grasping and Clamping Instruments

Can you
name these?
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Instruments Used in
Minor Surgery (cont.)
Retracting, Dilating, and Probing Instruments
Can you
name these?
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Instruments Used in
Minor Surgery (cont.)
Suturing Instruments
Can you
name these?
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Instruments Used in Minor Surgery
(cont.)
Syringes and Needles
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

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Asepsis
Two types are used to maintain the
safety of the patient and the health care
professional
Medical asepsis (clean technique)
Surgical asepsis (sterile technique)

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Medical Asepsis
Reduces the number of
microorganisms and
prevents the spread of
disease
Use personal protective
equipment
Use of sharps and
biohazardous waste
handling and disposal

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Surgical Asepsis
Purpose is to eliminate all
microorganisms
Common procedures using
sterile technique
Creating a sterile field
Adding sterile item to sterile
field
Performing a surgical scrub
Putting on sterile gloves
Sanitizing, disinfecting, and
sterilizing equipment

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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
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Apply Your Knowledge -Answer
1. Cutting and dissecting scissors, scalpels, curettes
2. Grasping and clamping forceps, hemostats, clamps
3. Retracting, dilating, and probing retractors, dilators,
probes
4. Suturing needle holders, needles, packaged sutures
Name at least one instrument for each of
the following types:
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Preoperative Procedures
Preliminary duties
Preoperative
instruction
Administrative and
legal tasks
Easing the patients
fears
Preparing the
surgical room
Preparing the Patient
Initial tasks
Gowning and position
the patient
Surgical skin
preparation
Cleaning the area
Shaving the area
Applying the
antiseptic
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Intraoperative Procedures
Preparing the local anesthetic you will need to
know:
Use of topical application
Use of injections
Potential side effects of the anesthetic
Use of epinephrine
Monitoring the patient
Processing specimens
Handling instruments

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Assisting the Physician
During Surgery
Serves as a floater
Monitoring and recording
Processing specimens
Other duties
Pouring sterile solutions
Keeping the surgical area clean and neat during the
procedure
Reposition the patient as necessary
Adjusting lighting.

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Assisting the Physician
During Surgery (cont.)
Sterile scrub assistant you perform a
sterile scrub and wear sterile gloves
Handling instruments in the following order:
Cutting instruments
Grasping instruments
Retractors
Probes
Suture materials
Needle holders and scissors

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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 patients chart

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Dressing the wound
Sterile material used to cover the incision
Serves to keep wound clean
Reduces bleeding
Absorbs fluid drainage
Reduces discomfort to the patient
Speeds healing
Reduces the possibility of scarring

Postoperative Procedures (cont.)
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Bandaging the wound
A clean strip of gauze or elastic material
Holds the dressing in place
May also 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 (cont.)
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Postoperative Instructions
Guidelines for pain management
Instruction for wound care
Dietary restriction
Activity restriction
Follow-up appointment
Provided in writing and included in the
postoperative information packet.

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Postoperative Information
Packet
Proper wound care
instructions
Suggestions for pain
relief
Dietary restrictions
Activity restriction
Timing for follow-up
appointments

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Surgical Room Cleanup
Place reusable instruments in a disinfectant
soak that has anticoagulant properties
Place disposable waste in the sharps or
biohazardous waste container
Clean the counters, exam table, and trays
according to OSHA guidelines
Disinfect small pieces of
nonsurgical equipment.

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Follow-Up Care
You 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.

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Apply Your Knowledge
What is the difference between a
dressing and a bandage?
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Apply Your Knowledge -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.
What is the difference between a
dressing and a bandage?

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Summary
Medical Assistant
You perform many functions during the patients
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 doctors right hand during the
procedure.
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End of Chapter