Question

CASE STUDIES SI CASE 1 wil You are assigned to scrub on a case, and you have just finished setting up the back table and instruments. The surgeons are gowned and gloved. The circulator is completing the skin prep Yc using an alcohol-based antiseptic. As soon as she finishes, the gi surgeons ask for drapes. You see that the patient's skin is still ra quite wet with the prep solution, and you hesitate in starting bl the draping, knowing that the prep solution has not dried. Your remark on this to the surgeon, and he replies, "Come on come on, let's get going on this." A few minutes later, the edge of the drape catches fire. The fire is quickly extinguished, re- vealing a second-degree burn of the patient's skin. Who do you believe is responsible? What documentation is needed? Who should be notified? CASE 2 Your patient is a 70-year-old man scheduled for a hernia re- pair. Your role is assistant circulator. The registered nurse cir- culator asks you to go to the holding area to see whether the patient has arrived. When you arrive at the holding area, the patient is there with the surgeon. The patient's speech is slurred, and he appears to have difficulty hearing the surgeon. As the surgeon looks over the chart, he notices that the patient has not signed the operative permit. He asks you to witness the patient's signing. What will you do? CASE 3 While scrubbed on a case involving surgical treatment of car- pal tunnel syndrome, you complete the instrument, sponge, and needle count. You are missing a needle. You tell the sur- geon that the count is incorrect. He replies, "Oh, don't worry. The needle can't be in the wound, it's too small. I would be able to see it. Let's close." What will you do? CASE 4 While in the locker room, you notice that one of your co- workers is emptying the pockets of her scrub suit. There are two vials of injectable medications. You cannot see what they are. She puts them in her purse and leaves. What do you do?

Answer 1

Case 1. Clearly I believe it's the surgeon who is responsible for this because I have told him already that the prep solution is not dried properly which was the cause of catching fire and caused second degree burn . Documentation should be written about the whole scenario what has happened and why . The incharge and the HOD should be intimated .

Case 2 - I will ask surgeon to wait a minute to ask the registered nurse circulator that will it be valid if I witness the patient's signing .

Case 3 - First of all I will tell him to see it properly because without that we cannot.close the wound and if he doesnot follows then I would inform the nursing incharge on duty in the operation room that a needle is missing and I asked the surgeon about it and he replied in such a way so that further actions can be taken by her .

Case 4 - I would inform about this to the nursing incharge ,that one of the staff has taken two injectable with her . Kindly see what the drugs are as we don't know for what purpose is she taking it and the second thing is that she has taken it with out permission and it's an illegal act .