AI Tools for Surgical Technologists

Compiled TKR instrument setup: procedure uses orthopedic instruments. Essential: oscillating saw (cut bone), burr/rasp (shape bone), cutting guides (accurate alignment), trial implants (to verify fit), final implants (femoral component, tibial component, patellar button, cement if not cemented), retractors (exposure), bovie (cautery for hemostasis). Positioning: supine, extremity elevated/prepped, knee exposed. Draping: split drapes, extremity drape to table. Setup: back table organized by surgical sequence (cutting tools first, then trial implants, then final implants). Surgeon may request different sequence—stay flexible. Communicate constantly with surgeon.

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Cutting Tools

Oscillating saw, burr/rasp, cutting guides

Implants

Trial then final: femoral, tibial, patellar

Positioning

Supine, extremity elevated and prepped

Setup Order

Cutting → trial implants → final implants

Compiled sterility breach protocol: NO—if glove touches non-sterile area, it's contaminated. Action: 1) Alert surgeon ("Glove touched non-sterile area"), 2) Surgeon removes glove/dons new sterile glove, 3) Reglove from sterile glove box. Why: to prevent introduction of bacteria into surgical site. Prevention: proper draping creates sterile field boundary, surgeon should be aware of placement. Key principle: ANY contact with non-sterile materials = contamination. This is how infections start. If you see a potential break in sterility, ALWAYS speak up—patient safety depends on it.

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Sterility Breach

Any non-sterile contact = contamination — no exceptions

Action

Alert surgeon → reglove from sterile supply

Prevention

Proper draping defines sterile boundary

Rule

ALWAYS speak up — patient safety depends on it

Compiled instrument care: debris on blade—rinse immediately with water (hot preferred) before debris dries. Use brush if needed, but don't force (risk damaging blade). Check for damage. Dull scissors—mark as "SHARPEN NEEDED," send to instrument repair. Don't return to OR until sharpened (dull instruments traumatize tissue). Process: 1) Inspect all instruments post-op, 2) Rinse off blood/debris, 3) Sort (clean vs. repair), 4) Sterilization (autoclave for most), 5) Store properly (dry, protected), 6) Arrange for repair as needed. Sharps: secure handling, never leave loose in dirty instruments. Broken instruments: remove from use, document, send for repair/replacement.

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Debris on Blade

Rinse with hot water immediately before debris dries

Dull Scissors

Mark "SHARPEN NEEDED" — do not return to OR

Sterilisation

Autoclave, instruments open, properly arranged

Sharps

Secure handling — never leave loose in dirty instruments

Compiled prone positioning safety: duration depends on patient factors (age, perfusion, padding). General rule: shift/reposition if >2 hours to prevent pressure ulcers. Complications: 1) Pressure ulcers (bony prominences—face, chest, pelvis, knees, toes), 2) Nerve compression (arms, legs), 3) Rhabdomyolysis (muscle damage from prolonged pressure), 4) Ocular complications (eye pressure). Prevention: padding under pressure points (gel pads, foam), positioning aids (chest rolls to reduce abdomen pressure), arms tucked safely (not over head too long—brachial plexus risk), legs padded apart (prevent common peroneal nerve compression). Monitor: check positioning regularly, palpate pulses if limb positioning compromises circulation. Document: positioning aids used, times of repositioning.

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Duration Limit

Reposition if >2 hours — prevent pressure ulcers at bony prominences

Pressure Points

Face, chest, pelvis, knees, toes — must be padded with gel or foam

Nerve Risk

Arms over head too long = brachial plexus injury risk — tuck safely

Ocular Risk

Monitor eye pressure — ocular complications reported in prolonged prone cases