Concorde Career College, Department of Surgical Technology Define the term computer List and describe the basic components of a computer system Understand basic word processing and the use of graphics Access the internet to gather information Apply basic computer skills to the educational process and to surgical case management Demonstrate knowledge of terminology related to computer skills verbally and in the written form Scheduling Send/Receive Orders Send/Receive Medical Records Update Pt. Chart Insurance Billing Update Surgeons Preference Card Manage and Print Instrument Count Sheets Order Supplies Complete Operative Record Laboratory Requisitions Surgical patient scheduling software Preference Card Applications As opposed to Hand written Often illegible Difficult to find Easily lost Can be taken with the surgeon to another facility Order Supplies and Instruments Maintain Inventory Par Levels Save and Manage Sterilization Records Create Instrument Tray Menu Cards Interdepartmental Equipment Transfers Track Equipment Maintenance Supply chain maintenance and ordering software The use of robotics in the OR is gaining in popularity among many surgical specialties Integrates complex computer science and mechanics STs are often required to maintain, manage, sterilize, and manipulate this equipment Must understand basic computer concepts in order to successfully function in the robotics-integrated OR suite Watch the following basic computer hardware tutorial: FnnGouYpQQFnnGouYpQQ Programs that operate the computer system and its individual hardware components Operating systems Word processing Internet Global network connected through millions of servers World Wide Web (www) is the most recent format for the Internet Photo and Article Access Each has address begins Not all Web addresses contain www Ending of address identifies what type organization publishes the information (.org,.gov,.edu, etc.) Search Engine Popular Search Engines Google, Bing, Yahoo Uses keyword or phrases to search for subject Usually first 20 30 articles directly pertain to subject Research for Homework and Projects Avoid using sites like Wikipedia that are not peer reviewed, professional data sources Prefer scholastic search engines to general search engines Google Scholar: iSeek: Library of Congress: Google Books: Science.gov: AST Website & Discussion Board Visit the state assembly Define the term electricity. Understand the basic principles of electricity. List and describe the types of electrical current. List and describe the basic components of an electrical receptacle. Analyze the relationship between magnetism and electricity. Identify basic electrical equipment utilized in the surgical environment. Apply knowledge of electricity to safe practice in the surgical environment. Demonstrate knowledge of terminology related to electricity verbally and in the written form. 24 Electrosurgery X-ray Endoscopes Lasers Robotics 25 Matter is anything that has mass and occupies space All matter consists of atoms Volume is the amount of space occupied by an object. Protons Inside nucleus and positively charged Neutrons Inside nucleus; neutral particles Electrons Revolve around the nucleus; negatively charged particles Atoms are composed of small particles: Protons Neutrons Electrons 26 Electrons revolve around the nucleus in paths called shells or orbits Electrons that are located closer to the nucleus demonstrate a stronger attraction the nucleus; electrons moving in the outer orbits are less attracted. In certain atoms, if these outer electrons are exposed to light, heat, or electric energy, they will speed up and leave the atom 27 These outer electrons are known as free electrons The movement of free electrons creates electric current The term electricity describes the free electrons moving or flowing from the ring of one atom to another 28 Materials that allow the flow of free electrons Examples: silver, iron, saltwater, copper Copper is the commonly used because its the most economical Examples of OR devices that use copper: OR lights, power drills, ESU 29 Because water is a conductor of electricity, the amount of humidity in the air is important High humidity often results in static charge leakage Low humidity results in the formation of sparks Humidity in the OR is maintained between 50% and 55% 30 Materials that inhibit the flow of free electrons Insulators are simply poor conductors Conductors are wrapped in insulation to prevent leakage of electrons while the current flows to the device that will use it. Examples of insulators in the OR are the plastic and rubber casings that cover the ESU cords Can be either negative or positive. Like charges repel each other, unlike charges attract each other. 2 negative charges or 2 positive charges will repel each other. ***Opposites attract*** (magnets) 31 32 Electric current is movement of the electrical charge The electrical current travels through conductors by movement of the free electrons that migrate from atom to atom inside the conductor Electrical potential Voltage: The force or push that moves free electrons from one atom to another. 33 Restricting the flow of the current Measured in ohms Opposing or counteracting force 34 35 Power the rate at which work is done (ex- battery) Power is measured in watts (W) Load the device that uses the energy (ex- flashlight bulb) Switch device that opens or closes a circuit and controls the flow of electricity (ex- between the battery and flashlight) Hot Wire: supplies electrical current in a circuit TO a device. Neutral Wire: AKA ground wire, carries electrical current in a circuit AWAY from a device. 36 Plugs used in surgery have 3 prongs. Components: First prong (positive) Second prong (negative) Third prong (ground) If electrical short occurs, the electrical current will flow through the grounded plug to reduce the risk of current passing through surgical team or patient. Must never be removed to fit in a 2 prong plug. 37 Direct (DC): electrical current that flows in one direction. Batteries Alternating (AC): electrical current that reverses direction periodically. A complete cycle moves in one direction and then reverses its course. Electrosurgery 38 39 Generator (power source) Active electrode (electrosurgical pencil) Delivers the electric current to the surgical site through the tissue, the energy is converted from electrical to thermal. Patient Dispersive electrode/inactive electrode (grounding pad) Electric current is channeled back to the generator via the grounding pad Placing the grounding pad p 112 40 Monopolar Most common Coagulation or cutting, or blend Large areas Grounding pad needed Bipolar Less frequent Only coagulation Delicate procedures Areas of moisture Grounding pad not needed 41 Harmonic scalpel Ultrasonic energy Cut and coagulate Surrounding tissue suffers less thermal damage (charring) A grounding pad is not necessary No electricity 42 Reduced blood loss Saves time Cutting current also burns tissue reducing the need to stop and control bleeding Cutting current seals small spaces in the tissue and lymphatic vessels 43 Electrical burns Patient and surgical team Resonant frequency (RF) capacitive coupling: AC travels from active electrode, across insulation and into skin. EX: surgeon clamps hemostat to bleeding vessel Dielectric Breakdown: occurs when high voltage breaks down insulating material (gloves) causing a hole and possibly burning the individual. 44 Different from ordinary light Monochromatic Coherent Collimated Its color will decide how it will react with various tissues Red laser light is absorbed by red-pigmented tissue Photon: a particle of LASER light energy 45 Fluence Spot size, watts, time Four interactions of laser with tissue Absorption, transmission. reflection, or scattering 46 Energy pump (excitation source) responsible for delivering the energy to the laser head to produce laser light - can be from any energy form (media) Laser head active medium that produces the laser energy. Lasers are named according to active medium. Mirrors are positioned at both ends of laser head. Laser energy is reflected off mirrors. Ancillary components includes the console, cooling system and vacuum pump Control panel controls for operating the system; includes wattage, duration, and mode Delivery system transports the laser energy from the laser head to the tissue. Ex articulated arm, fiber, fixed optical array 47 Carbon Dioxide Argon Nd:YAG Holmium: YAG **YAG=pulsed beam Most frequently used Invisible beam Helium-neon laser beam is transmitted with the Co2 laser to aid in aiming (red color) Permits precise cutting and coagulating Absorbed by cellular water content (not dependent on tissue color or consistency) Not effective for use where the laser light needs to be transmitted through clear fluids. Delivered through an articulated arm w/ mirrors positioned at the articulations. 48 Laser Bronchoscopy Dermatologic Pigmented lesions Shallow Tumors GYN HPV BX for abnormal PAP 49 Produces a blue or green light Plasma tube that contains argon $$$ Laser energy is converted to heat when absorbed, produces coagulation and vaporization. Can travel through clear fluids and tissues, absorbed in tissue by hemoglobin or melanin. Used in treatment for the eye 50 Eyes Bleeding vessels 51 Consists of crystal laced with neodymium. Invisible beam: requires helium-neon laser aiming beam Absorbed by darker tissue Can be transmitted through clear fluids. Used to vaporize bladder tumors Delivered through non contact or contract fiber delivery system. 52 TURP Urethral Strictures Bladder Tumors Hysteroscopy Uterine polyps fibroids 53 Discharges a pulsed beam Travels through flexible fiber Can be transmitted through clear fluids Used in arthroscopic procedures 54 LASIK Lithotripsy -Tripsy: crushing Lith/o:stone 55 Gas: Co2, Helium Neon, Krypton, Argon and Excimer Solid: KTP and Nd:YAG. (Most power output) 56 57 58 Improve surgical patient care Overcome human limitations Reliable Complex 59 Surgical technologists will be responsible for: Setting up the robot Running the computer programs Operating equipment during the surgical procedure 60 61 62