A great many smaller surgeries, that used to take place in a hospital setting, are now performed right in the doctor’s office. As a medical assistant, you will probably be called upon to assist with these in a variety of ways. These are some of the things you’ll need to know about.
Be knowledgeable of minor office surgeries and ways in which you may be required to assist the physician. Also, be able to explain these procedures in layman’s terms when providing patient education. These surgeries may include cyst removal, toenail removal, cryosurgery, skin tag removal, and colposcopy.
Know what surgical supplies are needed for different procedures. You may be required to have these ready for the physician prior to surgery. These include bandages, instruments, drapes, medications, etc.
Be familiar with surgical instruments for procedures. You may be required to prepare instruments or hand them to the physician when needed.
Here is a list of the things you need to learn about surgical instruments:
Classifications of instruments
Common instruments: hemostats, forceps, and scissors
Specialty instruments, such as those for gynecological and pediatric exams
Instrument parts: handles, locks, ratchets, serrations, teeth
Care and handling: sanitization, lubrication, sterilization, storage
Procedure for discarding disposable instruments
Sometimes, surgical supplies will come prepackaged. Know the items in different procedure trays and what other items may be needed.
Most surgical procedures are done sterilely, so the trays will be sterile. Practice opening the containers and maintaining sterile procedure.
Prior to incision, the skin must be prepped. Know which skin cleanser should be used for procedures, as well as how large the area of sterilization must be.
Review sterile field boundaries. When opening a sterile kit, the workspace that is sterile remains in the area of the container, unless otherwise compromised. Review what should be done in the event a sterile field is compromised.
You may be required to assist in post-op procedures. This may include stitching, bandaging, or incision education. Review bandaging techniques and discharge education for the post-operative patient.
Knowledge of medical terms and abbreviations is necessary to be a good medical assistant. This also includes knowledge and understanding of various medical procedures.
If you are unsure of a term, you can use word parts to learn it. For example, if you are unsure what the word ‘appendicitis’ means, you can break up the word. The suffix -itis means inflammation. The root word append means appendix. Appendicitis means inflammation of the appendix. Review word parts (prefixes, suffixes, and medical root or base words) and their meanings.
Using word parts can sometimes help with the definition of terms. However, some terms, like medical procedures or diseases, cannot be defined by word parts. Be sure to review common surgical and diagnostic procedures, as well as diseases.
Understand proper medical abbreviations and symbols. This also includes lab testing and electrolyte symbols.
It is important to spell medical terms accurately. Misspelling a word can change the meaning of a chart note entirely and could be dangerous for the patient. This includes procedures, diagnoses, and medications.
Infection control is extremely important in healthcare. Review ways to prevent spread of infections, including those commonly present in a healthcare setting (nosocomial infection). Methods include implement cleansing, disinfection, and sterilization.
There are community-acquired and hospital-acquired infections. Preventing the spread of infection in both settings is important. Be knowledgeable about how different viruses and bacteria are spread and methods to prevent their spread.
Different organisms require different settings or environments to grow and a host is needed. For example, fungi thrives in dark, moist environments. An example of this would be athlete’s foot, where fungi thrives in public showers. Review conditions of growth for different organisms, including bacteria, viruses, and parasites.
Depending on the type of organism, the mode of transmission can vary. Review organisms and their transmission category. Modes of transmission can include airborne, inhalation, and direct or indirect contact.
Review the 6 links in the chain of infection. Each link of the chain has a unique role and can be broken in different ways. The six links are pathogen (agent causing the infection), reservoir, portal of exit, means of transmission, portal of entry, and the new host.
The body has several natural barriers to prevent disease. The 2 lines of defense are physical barriers and the immune system. Review the different physical barriers and know the function of the immune system in disease prevention.
Protecting patients and workers from infection is not at all random. There are many guidelines and regulations in force to help us do this. Here are some that you should know and follow strictly.
Standard precautions are required for all patients. This includes the use of hand hygiene. Review other transmission precautions and the PPE required (airborne, contact, droplet).
The Centers for Disease Control (CDC) has issued standard precautions which are to be used for all patients. They include the use of hand hygiene and gloves. Review proper hand washing technique and know when to use gloves.
The Occupational Safety and Health Administration (OSHA) has a set standard to prevent and treat exposure of the worker. Review the standards of exposure to bloodborne pathogens, needlesticks, and body fluids. Also review what is included in Material Safety Data Sheets (MSDS).
Personal Protective Equipment (PPE) is used to prevent contact with blood borne pathogens. Be familiar with PPE. Know what to do if you are exposed to bloodborne pathogens.
Body fluids— include urine, feces, blood or any other body secretion.
Secretions— fluids produced by a cell, gland or organ
Excretions—release of waste matter
Blood—diseases passed through blood, such as HIV, HBV, and HCV
Mucous membranes—considered a natural barrier
Personal protective equipment (PPE)—includes gown, gloves, mask and goggles. (There is a specific procedure for donning and removing PPE.)
Universal precautions are used for all patients. This includes the use of gloves, hand washing, and using hand sanitizer.
Asepsis is the absence of any microorganisms, including bacteria. Review aseptic technique.
Medical asepsis refers to medical practice designed to reduce contamination of microorganisms.
Hand hygiene— Hand hygiene plays a huge factor in reducing the amount of microorganisms that come into contact with the patient and equipment. Review proper hand washing technique and know when the use of hand sanitizer or an alcohol-based rub is appropriate vs hand washing.
Sanitization— Sanitization of an exam room, instruments, and equipment involves cleaning with appropriate cleaning solutions. Some isolation precaution rooms require cleaning with a bleach-based cleaner.
Disinfection— Disinfection involves cleaning with appropriate cleaners. This includes equipment and instruments used for procedures. Be familiar with barrier precautions and the chemicals used for disinfection.
This refers to the sterile technique that is used in surgeries. In many facilities, a sterile field is to remain a sterile until the patient has left the room at the end of the procedure.
Surgical scrub— Before a procedure begins, the patient and surgical team must be appropriately prepped. Review required attire for staff during surgery, as well as the techniques for using sterile gloves, mask, gown, cap and eye protection. Also know methods for maintaining a sterile field and sterile draping techniques.
Sterilization techniques— Review methods for sterilizing instruments, towels, drapes, and dressings that are not disposable.
Autoclave— Review the preparation needed for equipment to be cleaned via autoclave. This includes proper wrapping and the use of sterilization indicators.
Other methods— Review chemical or gas methods of sterilization.
Order of cleaning—Review the proper order for cleaning equipment.
Packaging— You may be required to package materials for procedures. Review order of packaging for different trays.
Quality control— Review quality control methods for equipment, including maintenance. Also know about the use of indicator strips, sterilization logs, biological culture capsules, and date labeling.
Biohazardous waste is any infectious waste, including blood. There are specific guidelines for handling and disposal of such waste.
Regulated waste includes liquid or semi-liquid infectious waste (blood and body fluids). Review proper handling and disposal of sharps and infectious waste. Know how to clean spills appropriately and how to use a Safety Data Sheet (SDS).
Facilities have specific methods for recording the disposal of biohazardous and chemical waste. Review the proper use of these records.
Despite the best precautions, waste emergencies can occur. Review emergency procedures for them and know about post-exposure plans.