As a Operation Theatre (O.T) Technician

Iam An Operation Theatre (OT) Technician

Also known as a Surgical Technician or Operating Room Technician, plays a crucial role in ensuring the smooth and safe functioning of the operating room. Here's an overview of how an OT technician works:

    1. Preparing the Operating Room: OT technicians are responsible for setting up the operating room before surgery. This includes sterilizing and arranging surgical instruments, equipment, and supplies in an organized manner. They ensure that the operating room is clean and ready for the surgical procedure.

    2. Assisting the Surgical Team: During surgery, OT technicians assist surgeons, nurses, and other members of the surgical team. They pass instruments and supplies to the surgeon as needed, maintain a sterile field, and anticipate the surgeon's requirements.

    3. Sterilization: Sterilization is a  basic part of the OT professional's job. They are answerable for guaranteeing that all instruments and gear are appropriately Sterilized before every medical procedure to forestall diseases and keep up with patient security.

    3. Patient Preparation: OT technicians help in preparing the patient for surgery. This may involve transferring the patient to the operating table, positioning them correctly, and ensuring their comfort and safety.

    4. Monitoring Equipment: To make sure that the anaesthetic machines, surgical lights, and monitoring devices are operating properly throughout the process, they keep an eye on and maintain the surgical equipment.

    5. Infection Control: OT technicians adhere to strict infection control standards, which include good hand cleanliness, gowning, and gloving.

    6. Emergency Response: OT technicians should be ready to help during emergencies, such as by supplying extra tools or supplies at the request of the surgical team.

    7. Documentation: They keep detailed records of the surgery, including counts of the instruments used and any strange occurrences that may have occurred.

Overall, the work of an OT technician is essential for facilitating surgical procedures, preserving a clean and ordered atmosphere in the operating room, and guaranteeing patient safety. To deliver top-notch surgical treatment, they collaborate closely with surgeons, nurses, and other medical professionals.

                                 STERILIZATION

Definition: - It is the process by which all the micro-organisms (e.g.: bacteria, virus, fungi, spores) are completely destroyed &  Killed is called Sterilization

(CSSD= CENTRAL STERILE SERVICE DEPARTMENT)

 Antiseptics= chemicals used to kill micro-organisms on the surface of skin or mucous membrane are called as antiseptics.

Methods of sterilization: -

A) Physical methods

B) Chemical method/Antiseptics

C) Mixed method.

A) Physical methods: 

01) Radiation method

02) Heat method

03) Filtration method

01) Radiation method: -

a) Irradiation/High energy ionizing radiation 

b) Ultra violet light

c) Sun rays

a) Irradiation/ High energy ionizing radiation: -

i) X-rays

ii) Gamma rays

iii) Cathode rays

iv) Beta rays

v) Micro wave rays

USES:   Disposable syringes, plastic bags of glucose and blood, plastic bottles at industrial level are sterilized though these rays.

02) Heat method: 

a) Dry heat/Hot air

b) Moist or wet heat

a) Dry heat: 

 In this process of sterilization, materials are heated between 50-150ºC and more for 1-2 hour. This type of heat does not penetrate deep into the things as compared to moist heat. Examples of dry heat are flames, red hot cautery and hot air. It should not be used for AQUOUS FLUIDS, RUBBER AND PLASTICS.

b) Moist heat: 

i) Pasteurization

ii) Boiling

iii) Steaming

iv) Autoclave

v) Soaking

i) Pasteurization: 

 This method of sterilization was invented by Loe-Pateur. He invented that if alcohol is kept at 50-60ºC or milk is heated at 60.8ºC for half an hour or 71.7ºC for 15 seconds then all the bacteria are completely destroyed. But some spore forming bacteria (E.g. spores of TETANUS) remain intact.

ii) Boiling:  ( boiling water at 100 0C for 5 minutes)

   It is an old but common method of sterilization. This method of sterilization is commonly used in clinics. Syringes, needles, knives, scissors, blunt instruments and all the rubber goods are sterilized by this method. If 2% sodium carbonate (Na2 CO3) is added, more bacteria can be destroyed but bacteria that form spore remain intact. Sterilization of instruments is carried out by boiling for 45 minutes.

iii) Steaming: 

 If water is heated more than 100ºC it is evaporated and steam is formed. By passing steam, materials such as towels, gowns and dressings are sterilized. For this purpose autoclave or pressure sterilizer is used in which steam is further heated to 120ºC. All the spore forming bacteria are killed when they are subjected to this temperature with a pressure of 15Lbs/square inch for 30 minutes. Sharp and blunt instruments are also autoclaved.

iv) Autoclave ( moist heat): 

 This is a metallic, circular, close drum like machine used for sterilization in OT.  In this machine steam is heated more than 121 0C under pressure of 15Lbs for 15 minutes or 134 0C (30lbs/in2 pressure) for 03 minutes. 

 Gloves, gowns, towels, suturing materials, dressing bandages are sterilized. Under particular pressure for a particular time sharp instruments are autoclaved. 

 Pressure of the machine can be increased or decreased. In this process of sterilization, spore forming bacteria, tuberculosis bacilli, most viruses are also destroyed. It is not suitable for heat sensitive objects (like fiber optic endoscopes).

B) Chemical method/ Antiseptics:

 Chemical compounds are organic, inorganic and gaseous. They are used for sterilization they are also injurious to health. They are called antiseptic drugs. 

 Iodine, carbolic acid, Lysol etc. which come in contact with protoplasm of the bacteria and kill them. Chemical sterilization has to be performed on certain occasions e.g. in sterilization of the living tissues and catgut sutures since they are damaged by heat.

 Sharp instruments such as knives, knife blades, scissors, razors, osteotomies, saws, drill points are likely to become blunt on boiling, therefore they are chemically sterilized by immersing them into pure Lysol for30 minutes. Usually some of them are kept in solution so that they can be immediately used if required. Since the Lysol solution is soapy and injurious to the skin, the instruments must be rinsed in sterilized water before being handled.

 As the chemical sterilization is of doubtful efficacy, even the sharp instruments, after being wrapped and placed in special containers are either boiled or autoclaved in many institutions.

Chemical sterilization is classified into:

1) Oxidizing agents: 

     Hydrogen per oxide (H2 O2), Potassium per magnate (KMn O4), Hypochlorite, Chloramine etc.

2) Halogens: -

A group of Chlorine (Cl), Bromine (Br), Iodine (I) and Fluorine (F) 

a) Chlorine is used in drinking water, swimming pools, bath rooms, dairy things, feeding bottles, detergent powders and soaps used in kitchens. 

b) Iodine (Pyodine) is used for manufacturing tincture iodine in which 70% alcohol is used.it is used for skin preparation before operation and surgical scrubbing.

3) Alcohol and its compounds: -

      Alcohol (ethyl alcohol is used to clean the surface before venipuncture, to sterilize thermometers, stethoscopes.

4) Formaldehyde

 40% of formaldehyde gas is dissolved in water to form formalin. Formaldehyde gas in airtight cabinet at 50 0C is used for sterilization of rubber catheters, respiratory therapy equipments.

5) 2% Glutaraldehyde (Cidex)

 It is ten times more effective than formaldehyde. It destroys micro-organisms rapidly and is active against Hepatitis B virus, HIV. However it has low efficacy against spores and has little effect against tubercle bacilli. It is also used for sterilization of endoscopes (which are heat sensitive).

6) 0.1 % sodium hypochlorite (Cetrimide):

It acts by releasing chlorine to damage bacterial cell wall; most bacteria are killed within 30-60 seconds. Fungi and viruses are extremely susceptible but tubercle bacilli are more resistant. It is commonly used to disinfect baths, cradles, and furniture and lavatory seats. It is also used for hand washing.

7) Ethylene Oxide (EO) = it is gas, used for sterilization of sutures, lenses, electrical components. Its use is limited because of its volatile and inflammable nature and high cost.

8) Heavy metal compounds: 

    Silver, mercury, copper etc. are called heavy metal compounds. They are used to kill the fungus.    .

09) Phenol or carbolic acid

It is used for badly infected sanitary units

-Phenol is germicidal in strong solution, Used as a "scrub" for pre-operative hand cleansing. 

10) OTHERS: 

Chlorhexidine=It is used for skin preparation and surgical scrubbing.

By adding chlorine in xylenol, Dettol is formed. (Dettol is chlorinated xylenol).

C) Mixed methods

Sometimes both physical and chemical methods are used e.g. dry heat and radiation both can be used along with certain chemicals.

SUMMARY

                 Object                                 Sterilization Method

Dressing, Gloves:                            By Autoclave

Catheters, syringes, I/V cannulas:      Gamma rays

Eye instruments:                                     Hot air

Heat sensitive instruments/Plastic:     Ethylene oxide

Laproscopic/Endoscopes:                       Cidex/Peracetic acid

Skin of Patient:                                 Pyodine, Dettol, alcohol

Surgical instruments:                         Autoclave, boiling

OPERATIONS/ PROCEDURES PERFORMED IN LITHOTOMY POSITION

01) Sigmoidoscopy

02) Abdomino-perineal resection of Rectum. (A P R).

03) Laparoscopy.

04) Cystoscopy.

05) Ultrasonic Lithotripsy.

06) Prolapse of Rectum.

07) Recto Sigmoidoscopy.

08) Anal fissure.

09) Fistulectomy.

10) Perineal dissection for Ca: Rectum.

11) External urethrotomy.

12) Hemorrhoidectomy.

13) Trans urethral resection of prostate. TURP (in male only)

14) Complete amputation of penis in case of cancer.  (IN male)

15) Dilatation of cervix and curettage of uterus. (D&C). (in Female)

16) Therapeutic abortion by suction curettage. (In Females)

17) Anterior colporrhaphy. (in Females)

18) Posterior colporrhaphy. (in Females)

19) Tuboplasty of fallopian tube. (In Females)