PRESURGICAL PROCEDURES

During the presurgical procedures, you will receive the patient, and prepare the surgical room. To maintain asepsis in the surgical room, you may need to take a number of special measures. The members of the surgical team may wear sterile, disposable gowns over their regular working uniforms, surgical caps, masks, and hoods (if bearded). Scrub the patient's face and drape the patient with sterile drapes. The dentist and the scrub assistant (or other team member) must perform a surgical scrub and put on sterile surgical gloves and gowns before any oral surgery procedures begin.

RECEIVING THE PATIENT

As the circulating assistant, you will receive the patient once the surgical suite is prepared. Surgery patients may be nervous or fearful; take special care when receiving them.

Seat the patient and make them as comfortable as possible. Direct the patient to loosen any tight clothing, remove eyeglasses and any removable dentures. If the patient has dentures, place them in a container of water and put their eyeglasses in a safe place.

Before starting any surgical procedure, the circulating assistant will take the patient's pulse and blood pressure. ;The patient's vital signs will be recorded on the EZ603.

The dentist will usually stand when performing oral surgery. Position the dental chair so that the patient's head is at the level of the dentist's elbow. If the surgery is to be performed on the maxillary arch, position the chair so that the patient's alatragus line is at a 35° angle to the floor. For surgery on the mandibular arch, position the chair so that the patient's alatragus line is parallel with the floor.

PREPARING THE SURGICAL ROOM

After the patient has been seated, the circulating assistant prepares the surgical room for the surgical procedure. Arrange the instrument stand (Mayo stand) with the following instruments and materials:

Patient scrub setup.

Surgical drape pack.

Two packs of disposable, sterile gloves.

A simple or complex surgical extraction pack, plus any additional instruments or materials requested by the dentist. Place the pack(s) on the Mayo stand. Position the stand to the rear of the dental chair so that the instruments are within easy reach of the dentist and the scrub assistant.

Anesthesia pack (if one is not included in the extraction pack).

NOTE: Do not open any of the packs at this time.

Once the instruments and materials have been set out, the circulating assistant gets ready to perform the patient scrubbing procedures.

PATIENT SCRUBBING PROCEDURES

The circulating assistant scrubs the patient's face. During the scrub procedure, take special care to see that patients with facial hair, makeup, sores, or skin infections are thoroughly cleansed. The scrubbing procedures are as follows:

NOTE: The circulating assistant must wear gloves when performing the following steps.

Place a hand towel on the patient's chest to keep the patient's clothes from being stained. Tuck the top of the towel inside the patient's collar. (Use another hand towel if you need more coverage.)

Saturate two 4 x 4 sterile gauze sponges with the surgical soap solution.

Use both sponges to scrub the patient's cheeks, nose, and chin. Work up a good foaming lather and be sure to scrub the area beneath the chin. After 1 minute, discard the two sponges, then with two new sponges, continue the scrub. The entire process should take approximately 2 minutes.

After the scrubbing procedure is completed, blot the excess lather with a sterile towel.

SURGICAL TEAM SCRUBBING, GLOVING, AND DRAPING

While the circulating assistant finishes preparing the patient, the dentist and scrub assistant will prepare for surgery. The circulating assistant will help the other team members during the following procedures.

Scrubbing

The dentist and the scrub assistant will perform the same procedures, which requires an antimicrobial