Surgical Hand Scrub

Surgical Hand Scrub


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.


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