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.