Table Of Content00Goldman(F)-FM 10/19/07 9:25 PM Page i
Pocket Guide
Operating
to the
Room
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Pocket Guide
Operating
to the
Room
T H I R D E D I T I O N
Maxine A.Goldman,BS,RN
Clinical Nurse IV
Formerly, Operating Room Clinical Education
Instructor
Medical Center of Tarzana
Tarzana, California
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Library of Congress Cataloging-in-Publication Data
Goldman,Maxine A.,1947-
Pocket guide to the operating room / Maxine A.Goldman.— 3rd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN-13:978-0-8036-1226-6
ISBN-10:0-8036-1226-5
1. Surgery,Operative—Handbooks,manuals,etc. 2. Surgical instruments and
apparatus—Handbooks,manuals,etc. 3. Operating rooms—Equipment and
supplies—Handbooks,manuals,etc. I. Title.
[DNLM:1. Surgical Procedures,Operative—methods—Handbooks.
2. Operating Rooms—Handbooks. 3. Surgical Equipment—Handbooks.
WO 39 G6193p 2008]
RD32.3.G65 2008
617′.91—dc22 2007036130
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00Goldman(F)-FM 10/19/07 9:25 PM Page v
I dedicate this work to those special registered nurses and
surgical technologists who are entrusted daily with the
responsibility of the care and safety of patients in the
perioperative environment.
M.A.G.
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Preface
Although the format appears the same as in previous editions, this
third edition of Pocket Guide to the Operating Room reflects completely
revised and thoroughly researched “state of the art”material that will
enable the practitioner to elevate his/her level of perioperative patient
care to new standards of excellence.The reader will find approxi-
mately 100 new procedures or their modifications in this third edition;
previously included procedures have been updated to reflect current
knowledge of evolving technology and perioperative patient care
measures.Chapters containing the latest information on advanced sur-
gical modalities employing lasers,endoscopy,robotics,microsurgical
techniques and instrumentation,the Harmonic®and Plasma®scalpels,
the Argon beam coagulator®,and radiofrequency ablation are included
and cited throughout the work.New chapters on various dental and
orthognathic procedures and intraoperative radiotherapy are pre-
sented. New surgical entries and/or approaches to previously
described surgeries include total joint replacement surgeries;
microneuroendoscopy; prosthetic disc replacement; micro, percuta-
neous,and endoscopic discectomy;percutaneous vertebrpoplasty and
kyphoplasty;and multiple approaches to correct scoliosis.The chapter
on pediatric surgery provides comprehensive measures with explana-
tions particularly designed for the care of the child in surgery. My
intent is to continue to limit the text’s physical size for convenience
while maintaining the concise format of previous editions and describ-
ing perioperative care with an emphasis on the intraoperative phase.
The most recent principles, standards, recommendations, and/or
mandates set forth by the Association of periOperative Registered
Nurses (AORN),the Joint Commission (JC) [formerly the Joint Com-
mission on Accreditation of Healthcare Organizations (JCAHO)],the
Centers for Disease Control and Prevention (CDC),the Occupational
Safety and Health Administration (OSHA),and the North American
Nursing Diagnoses Association (NANDA) International have been
incorporated into the text.
Measures for providing psychological support and physical safety
of the patient in the perioperative environment are emphasized in this
edition,particularly in the expanded Special Notes section at the end
of each surgical entry.The Special Notes also serve to alert the circu-
lator and the scrub person to important information that may not nec-
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viii Preface
essarily be found elsewhere.This information assists the practitioner
with anticipating and predicting the perioperative needs of the patient
and the surgical team members.The reader is encouraged in Chapter
1,and throughout conduction of the surgical procedures in Part 4,to
assess individual needs unique to the surgical patient by developing a
plan of care and by implementing that plan of care according to cur-
rently established safe standards.Perioperative practitioners are also
encouraged to evaluate the effectiveness of implemented care by
examining patient outcomes to maintain a level of excellence.The dis-
cussion section for each surgery includes information on the applica-
tion of “state of the art”technologic modalities and updated surgical
techniques. More than 500 surgical procedures are presented in a
preestablished,standardized format.Each includes a definition,a dis-
cussion, and a description of each procedure, as well as notes on
preparation of the patient and safe positioning practices,skin prepara-
tion, draping techniques, equipment, instrumentation, supplies,
and Special Notes pertinent to patient care for each procedure. In
the Special Notes section,the perioperative practitioner is alerted to
care measures of particular importance that are preceded by the
notation N.B.
The conduction of a surgical procedure may appear to differ from
institution to institution, between different sections of the country,
and according to the preferences of individual surgeons,but the com-
mon goal regarding the best outcome for the patient remains the same.
As noted in the previous editions,the particular equipment,instru-
ments,and supplies suggested for use are not to be regarded as exclu-
sive.Rather,the suggested surgical items represent those that are basic
and commonly used;items can be added or deleted according to pref-
erence. Draping techniques, instrument nomenclature, equipment,
supplies,etc.will also vary accordingly.Precise details regarding cer-
tain items such as suture material have been omitted due to the ever-
increasing availability of products and brands.
In this edition,the bibliography lists references that include perti-
nent Internet sites.As in previous editions,the text is reflective of the
most current drug information with reference to safety precautions
and includes anesthetic agents and their administration in their respec-
tive chapters.An encyclopedic reference to every surgical procedure
has not been attempted.Infrequently performed procedures or those
procedures performed only at select surgical facilities,such as organ
transplantation surgery, complex cardiac procedures, etc. have been
omitted.
Incumbent upon the perioperative practitioner is the need to ever
expand knowledge on a daily basis, to provide a continuum of safe
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Preface ix
patient care in the perioperative environment,and to adapt the latest
surgical modalities to established basic concepts.I hope the informa-
tion presented herein will serve as a generally applicable foundation
upon which to build.
M.A.G.
