a. General.

The circulator has the best opportunity to see breaks in aseptic technique.

However, the scrub and all of the other team members in the operating room are also responsible for watching for breaks in technique. Whenever such a break is observed, the team member who sees it should speak up at once so that the necessary corrective measure can be taken.

b. Circulator.

The circulator must be alert to any break in sterile technique and observe the following rules.

(1) Do not touch or reach over the sterile field. When placing sterile items, transfer is made to the edge of the instrument table.

(2) Face sterile areas when passing; do not pass between two sterile areas or two sterile team members.

(3) Do not touch the edge of the cap or lid to the edge of the container into which sterile solutions are poured.

(4) Wash hands vigorously for at least 15 seconds after each patient contact or handling contaminated items.

(5) Keep conversation to a minimum. Keep hair covered and mask inplace. Change masks when necessary.

(6) Decontaminate floor and walls promptly during the operation if they are contaminated by blood or other organic material. Local procedures will identify the disinfectant solution you will use. Prompt decontamination will prevent microorganisms from drying and becoming airborne.

c. Scrub.

The scrub must constantly maintain sterile technique and watch for breaks as he observes the following rules.

(1) Step away from the sterile field if contaminated and request fresh sterile attire from the circulator.

(2) Change glove immediately and discard the needle or instrument if a glove is pricked by a needle or snagged by an instrument.

(3) Discard suture material, tubing, or sponge that falls over the edge of the sterile field.

(4) Keep hands at waist level, never below the waist.

(5) Keep contact with the sterile field to a minimum. Never lean on or against the operating table, Mayo stand, instrument table, or patient.

(6) Leave a wide margin of safety when moving about the room. When passing nonsterile objects or persons, turn your back to them.

(7) Face sterile areas when passing them. Do not turn your back to the sterile field.

(8) Pass another sterile team member back to back. Do not reach behind a sterile team member.

(9) Keep the sterile field and table as dry as possible.

(10) Discard soiled sponges from the sterile field.

(11) Avoid coughing and sneezing. Keep talking to a minimum.

d. Hair.

The patient’s hair will be covered before he is brought into the operating room. This measure protects the sterile setup from the microbial population in the patient’s hair. In addition, it prevents the discharge of static electric sparks from the patient’s hair.

e. Sheets.

The team member who brings the patient into the operating room is to loosen the sheets covering the patient before transporting him into the room. This measure prevents the creation of static electricity and prevents the need for vigorous handling of the linen in the room, thus avoiding the scattering of microorganisms from this source.