Hello. I'm Mike from Surgtech Academy and today I'm going to demonstrate the
surgical hand scrub. A surgical hand scrub is performed after we've opened
supplies and before we gown in glove. We scrub our hands so that we lower the
risk of hospital-acquired infections by reducing the number of transient and
resident flora. Now although we can't consider our hands sterile after a
surgical hand scrub we can call them surgically clean. Now there are three
methods of getting our hands surgically clean. These methods are the timed method.
The old-school method was five minutes but new research has shown that three to
four minutes of scrubbing is just as effective, with less cell damage, and less
cell shedding to our skin. Then we have the counted brush or the stroke method
of which I'm going to demonstrate here. And then lastly we have the waterless or
brushless method that I've already shown in a previous video. Next i want to talk
about some antiseptic agents. In our lab we use three percent PCMX, which is
cloraexylol. And all we use 4% CHG, chlorhexidine gluconate. And then we have
good old-fashioned providone iodine. I still love that stuff
for those students that have skin sensitivity issues. Now there are some
key ideas that I want you to remember for the surgical hand scrub. One, we scrub
our fingertips to two inches above the elbow. We make sure to keep our finger
tips always above our elbow. We scrub all four anatomical planes and we're avoid
contact with any non sterile surface such as the sink head or the sink itself.
Now make sure you follow hospital policy as to which method your hospital uses. So
I have my personal protective equipment on and I've already opened. My scrub top
is short. Now if your scrub top has to be longer you can roll your scrub top, you
can tuck it under your bra strap, whatever you have to do so that you can
get two inches above your elbow. Alright, next I'm going to demonstrate.
I'm gonna assemble my package and I'm gonna open my package. I like to keep the
nail pick and the brush in the same hand. I'm gonna turn on the water. You can
adjust the level of water and you can adjust the temperature. I think it's fine
where it's at. I'm gonna get my hands wet.
Next I'm going to take the nail pick and dig underneath my nails under running
water.
Next I'm gonna work up a little lather. Turn off the water.
Water conservation is always good isn't it. Should be a key to any hospital or
any operating room. So next I'm gonna scrub both sets of
nails for 30 strokes each. One stroke is back and forth. I do both sets of hands
first. I have found that students tend to, if they do one set of nails and then the arm
they tend to forget the second set of nails for some reason. So I do both sets
of nails at the same time 30 strokes.
Then we want, we can actually take off the brush, so that we just have the
sponge left. I've found this is good for a couple of reasons. Alright, one, using
the brush on any part of our skin actually, again, increases cell
shedding. So my students tend to remove the brush and the sponge is a lot more
flexible and it's good for getting into webbing. So we tend to do that. Next I'm
going to divide each finger into four planes and scrub each plane ten times.
At this point I also want to get the webbing ten times.
Notice that I have actually moved away from the sink at a 45 degree angle. This
helps make sure that I don't accidentally touch the sink head. And
also notice that my fingertips are always above my elbow and all I am doing
is rotating my arm on an axis.
Next we do every section of our hand. Back of the hand, side of the hand, palm
of the hand, and the other side of the hand. And again we do this ten times.
After we've done our hand then we're going to do our arm. Basically we divide
our arm into three different sections. And you guessed it, we scrub each section
ten times. Now never do this, but just to give you an idea of how why we have to
scrub, if I take my sponge and do it three different times, three different
sections, I'm going to get within two inches above the elbow. So our circles
don't have to be that big.
Alright I'm gonna switch hands. At any time we can add more soap or more water
to our sponge. I'm gonna add a little water. We've already done our nails so we
can go straight to the thumb. Webbing.
On to our hand, also ten circles.
Now to our arm.
It should be noted that if at anytime I drop my sponge there's a couple things I
can do. Alright, one, if my circulator's around I can have my circulator grab me
a new sponge. Or two, I can rinse my arms and completely start over.
Now at this point we can throw our sponge into a waste receptacle or we can
throw it down in the sink. I'm gonna throw it down in the sink. Now rinsing
the arms. We want to rinse from our fingers to our elbows. In an upward
motion. Sometimes I tell my students it's like giving an uppercut to somebody.
So no back and forth. One fluid motion.
That's it. At this point I would back into the operating room with my hip,
making sure that my fingers are always above my elbows and from my shoulders to
my axilla. So that's it. A very basic and crucial skill in our days in surgery.
And also a skill that I've seen many practitioners become a bit lazy with. So
from Mike at Surgtech Academy I'm wishing you a good day in surgery and
reminding you to be a superstar in the O.R.