a. Just as the circulator has specific responsibilities in the operating room, the scrub has specific duties and responsibilities.

(1) Although all the members of the surgical team have a responsibility for the sterility of supplies, the scrub has a particular responsibility. In order to function both effectively and efficiently, he must familiarize himself with the routine established by the hospital as well as the routine followed by each surgeon with whom he scrubs.

Only with continued practice and experience can the specialist become a competent assistant at the operating table, but the specialist’s experience will take on added meaning if he fully understands what is expected of him. Although surgeons vary in their techniques, the procedures outlined in the following paragraphs are in general use. Additional procedures in setting up will be required for specialized surgery.

(2) The scrub, coordinating his activities with those of the circulator, is to follow an established routine in preparing the sterile setup. Following this routine serves several purposes. It enables the scrub to save time and effort, thereby reducing his fatigue. In addition, when the established routine is known and practiced by all, a scrub can be relieved at any point in the procedure without delaying the case and thus endangering the patient. Again, the order in which the tasks are performed is somewhat flexible, but, in general, the sequence in the following paragraphs is used.

b. The scrub is a sterile member of the operating room team, so from the time the scrub starts the surgical scrub until the operation is completed and the dressings applied, there is a division between the duties of the scrub and circulator which neither may cross. While there is a definite division of duties, they must cooperate so that the operating suite functions efficiently and will serve the patient’s best interests.