BY EVELEEN HARRISON, Graduate of the Post-Graduate Hospital, New York.
_From the American Journal of Nursing._
Of necessity this is far more extensive than the requirement of a minor
operation, and should be commenced the day before if possible.
The selection of the room comes first, and as an abundance of clear
light is more essential than anything else in an operating-room, let
the choice of the room depend on that. When possible avoid using a
room into which the sun will shine directly during the time of the
operation; but in any case, take the room that gives the most light.
When the house is large enough to allow it, and your choice is not
limited, use a room adjoining, or at least on the same floor as the one
to be occupied afterward by the patient, and as near the bath-room as
possible.
Sometimes it is necessary to use your patient’s bedroom, in which case
the bed, after being prepared, should be pushed up in a corner out of
the way.
All the furniture that it is possible to remove is taken out of the
room; any large piece that has to remain should be covered completely
with sheets fresh from the laundry. Carpets and curtains must be
removed, _unless the surgeon prefers to have them covered with moist
sheets_, and the room thoroughly cleaned, floor scrubbed, windows
washed, etc.
As the surgeon will need all the light you can give him, cover only
the lower panes of the window with thin muslin curtains, cheese-cloth,
or—what will answer the purpose equally as well and is ready at hand—a
thick lather of soap rubbed all over the panes and allowed to dry, thus
shutting off the gaze of outsiders without excluding valuable light.
The temperature should be about 75° F. and the room well aired
beforehand, as no window will be opened during the operation.
A list of articles usually required for a major operation is as follows:
Bandages.
One strong kitchen table.
Four small tables.
Three common chairs.
One fountain syringe.
Three large basins and pitchers.
One small basin and pitcher.
One piece of rubber sheeting for table.
Two slop-jars or foot-tubs.
One gallon of hot boiled water.
One gallon of cold boiled water,
and always keep a kettle of water boiling on the stove.
Antiseptic solutions as ordered.
Alcohol.
Safety-pins.
Green or synol soap.
Absorbent cotton.
Sterilized gauze.
New wooden nail-brush.
Two dozen towels, and plenty of clean soft cloths.
This list is an outline of the articles usually required; the surgeon
will supplement what is necessary for each particular operation, but
when a nurse is called upon to prepare for an operation in a private
house, where the conveniences of the hospital are not at hand, she will
be thankful to have ready a list of the things that are indispensable.
I well remember my first operation outside the hospital, and how
difficult I found it to construct a modern operating-room from the
limitations of a small country house.
All supplies, when possible, should be on hand the night before the
operation, and the room cleaned ready for work.
Facing the best light, and about five or six feet from the window,
place the kitchen table, and cover it with a double blanket or
comfortable, rubber sheeting, and a sheet fresh from the laundry, the
whole pinned firmly at the four corners with safety-pins. Lay on the
top a small single sheet, a blanket, and very small, firm pillow.
The little tables are to be arranged around the large one, leaving
plenty of room to walk between. Cover them with sterilized sheets; if
they have polished tops, first put on a piece of oilcloth or rubber
sheeting to prevent damage. These tables are for the instruments,
gauze, sponges, sterilized towels, and basin of solution for the
surgeon’s hands.
A strong screw must be fastened in the wall near the window at the
height of about seven feet to support the fountain syringe, which will
be filled with whatever solution the surgeon requires for irrigating
the wound.
One slop-jar stands at the side or end of the large table, the other
beside the table that holds the basin of sponges.
The bureau (covered with a sheet) or the mantle-shelf will serve to
hold the dressings and rubber gloves. A small stand or table will be
needed by the doctor who gives the anesthetic for his hypodermic, clean
towels, and ether or chloroform.
All the basins, towels, and pitchers to be used during the operation
must be thoroughly washed in warm soap suds and then boiled for an
hour, or—when that is not possible—allowed to stand all morning in a
1: 1000 bichlorid solution, and then rinsed off with sterilized water
before using. Two of the basins are filled with sterilized water or
salt solution for washing the sponges, another basin holds the wet
sterilized towels, and the fourth the solution for the surgeon’s hands.
A small bowl is needed for the soft soap to wash off the part of the
body to be operated on, also a small pitcher of 1: 2000 bichlorid and
some alcohol.
In the bath-room arrange plenty of clean towels, a bowl of 1: 2000
bichlorid, and one containing alcohol, synol, or green soap, and a
sterilized nail-brush for the surgeon’s hands. The surgeon will send
instruments, sutures, and anesthetic.
You cannot err in having ready a good supply of sterilized water, as
an emergency may arise in which a double quantity would be required.
Clean the wash-boiler thoroughly, fill it almost to the top, and boil
for half an hour. One boilerful must be prepared in time for the water
to grow cold before the operation; it is then poured into pitchers that
have been washed in warm soap suds, and rinsed off with the sterilized
water. Cover the pitchers with sterilized towels or napkins.
It is of the utmost importance that everything should be in perfect
readiness when the surgeon arrives. The nurse will do well to go over
the list carefully, so that nothing may be missing.