Opening a Room for the First Case

In practice

It is six thirty in the morning. Jamie, the surgical technologist, and the circulating nurse enter the restricted zone in scrubs, head coverings and masks. The room was terminally cleaned overnight, and they check that surfaces are clean and dry and the floor is clear. They read the preference card for the first case, a hernia repair under general anesthesia. The circulating nurse checks the operating table: it raises, lowers and tilts as it should. The armboards, gel pads and a safety strap are in place, as the card requires. Jamie tests the suction and confirms it pulls well. The electrosurgical unit powers on and runs its self-check; the circulator sets out a dispersive pad of the right size and checks its expiration date. A smoke evacuator is in the room with new tubing ready. The warming device is plugged in and working. The anesthesia provider arrives to complete the anesthesia machine's daily check. The circulator confirms from the processing department's board that the steam sterilizers passed their morning air-removal tests. Only then does Jamie begin opening sterile supplies, starting with the back table pack. Before the first package is opened, Jamie checks its outside for damage and moisture, as every package is checked, because a room that is ready is still only as safe as the first item placed on the field.