TOPIC 5: MATERIALS AND INSTRUMENTS FOR MEDICAL USE.

THE PRIESTS' CAR

1. MEDICAL-SURGICAL INSTRUMENTS

MEDICAL-SURGICAL INSTRUMENTS: is the set of objects used in surgical interventions.

The parts of a medical-surgical instrument are:

Depending on the number of times it is used:

•
cannulas…
Disposable material: used and thrown away. For example: bandages, dressings, needles,

• Reusable material: after being used, it is cleaned, disinfected and sterilized, so that its
reuse is safe.
Materials:

• It is usually made of stainless steel

• Metal materials: aluminum (containers), chrome-plated brass (accessories)
• Plastic materials:
■ Heat sensitive: PVC (polyvinyl chloride)
■ Compact and pearly appearance: silicone (masks, endotracheal tubes)
■ Rubber: cables, nipples
■ Latex (limited use due to allergies)
■ Silkolatex (corrugated tubes)
• Very hard materials: very hard plastics.
• Glass and ceramic materials: lenses, baby bottles, flasks…
Characteristics that medical-surgical instruments must meet:

• Be resilient
• Non-oxidizing
• Do not reflect light
• Dismantle completely or partially
• Be easily cleanable
DMSU: single-use medical devices, examples: trocars, stents, catheters, electric scalpels,
compresses, gauze…
2. MAINTENANCE OF MATERIAL

P MAINTENANCE PHASES:
 1) Cleaning, review and functionality
• Perfectly clean instrument
• Free of organic remains and dirt
• Remove worn and defective instruments (they do not fulfill their function)
• Separate corroded instruments (so that they do not come into contact with
instruments in good condition)
2) Drying:
• Thorough drying
• Check if it is dry
• If the material is not dry enough:
■ It will prevent proper sterilization
■ Steelmaking the oxidation process
3) Lubrication:
• If necessary it should be done manually
• If mechanical washing is used:
■ General lubrication is guaranteed
■ Material with joints, closures and cutting edges: require manual
lubrication (to eliminate friction)
• Application of a lubricating film:
■ It must be fine
■ Applied directly or by vaporization
• It is important to know and follow the manufacturer's instructions

> CAUSES OF MATERIAL DETERIORATION:

•Insufficient cleaning
•Failure to meet your specification
•Unsuitable products
•Remaining waste
•Poor water quality
•Steam residue
•Medicine residues, markers, chemical indicators...
•Errors in its use
•Do not use it for its designed purpose.

> PROBLEMS OR CONSEQUENCES:

• CORROSION: is one of the main problems with metal instruments. You must:
■ Chlorine ions in water
■ Sodium salts (part of blood)
■ Organic substances
■ High temperatures in the cleaning and sterilization process (causes oxidation)
 • TYPES OF CORROSION:
■ BY TENSOCRACK: due to the overstressing of the material
■ BY STING OR SELECTIVE: by contact with salts and chlorides
■ INTERLAYED OR BY FRICTION: by continuous friction
■ BY CONTACT: between healthy and rusty instruments
3. TYPES OF INSTRUMENTS ACCORDING TO THEIR FUNCTION:

> EXPLORATION MATERIAL: It is used as a means to facilitate the examination of the patient,
according to the different anatomical areas.

IMAGE NAME USE

«0 “t"
Explore the osteotendinous
Reflex hammer reflexes

7 Ophthalmoscope
Allows you to observe the back
of the eyeball (fundus)

X rhinoscope
Allows you to explore the nasal
passages

Allows you to auscultate

Stethoscope
physiological sounds (cardiac,
phonendoscope
4 respiratory, abdominal)

(°F - 4 It has an accessory light that

—0 Front mirror allows you to properly illuminate
the area to be explored.

/
Instrument that explores hearing
Diapason and air and bone transmission
4
Sphygmomanometer Allows you to collect blood
Blood pressure monitor pressure

Tongue depressor Exploration of the oral and

oropharyngeal cavity

Yo
Allows exploration of the
Otoscope auditory canals

A
m Laryngoscope
Exploration of the larynx
Intubation

P Pinard Obstetric
Stethoscope
Allows the fetal heartbeat to be
auscultated

• Cephalometer
Allows you to measure the skull
of babies

Laryngeal mirror Allows exploration of the mouth

Intraoral mirror and larynx

1) or Sterile lancets
It is used to extract capillary
blood and small punctures.

Allows exploration of a wound,

qi VN Fluted probe
fistula or duct Facilitates fluid
drainage

/ Buttoned stiletto
To explore a wound, fistula,
duct, etc.

TO
Vaginal speculum Visual examination of the vagina

Intubation
Magill tweezers Forceps for introducing
catheters
> DRAPING OR FIELD instruments: USED TO HOLD THE FIELD DRAPES THAT ARE PLACED ONCE THE PATIENT HAS
BEEN PREPARED ON THE SURGICAL TABLE.

IMAGE NAME USE

Brl
Clamp for holding surgical fields
Jones Crab Pinocets (1st field)

Clamp for holding surgical fields

Doyen clamp (2nd field)

8
TO
Forceps for holding surgical
Backhaus clamp fields

F Forceps for holding surgical

Co Robin's claw fields

> “Cutting” diaeresis instruments: They are used to divide and cut tissues
(sharp material)

tips are blunt the other is fine. you are

blunt.

There are scissors of different sizes, straight and curved depending on the shape of their active
part, sharp or blunt or mixed tips. Adapted to each specialty.

IMAGE NAME USE

1 Escape it
Non-detachable
scalpel (classic)

It consists of a handle
Scalpel and single-use blades.

=sstz= ----------

It is commonly used in
surgery. At the same
Electric scalpel time it cuts, it
separates the tissues.
 Bandage It is used to cut
( iff/ \ o scissors with bandages and
clothing.
buttoned tip

00

\ Straight May
Scissors They are wide and
strong. They are used

ii
to cut hard tissues.

V
I

They are wide and

Curved May
Qp

strong. They are used

Scissors to cut hard tissues.

For cutting bandages

Lister scissors and clothing
Its purpose is to

II
If
with buttoned
tip
introduce it under the
bandage without

J1 1 ~ or injuring the patient.

V।। ) They are thinner and

longer.
They are used in the
Metzembaum
dissection of tissues
scissors

and 11 II and
(vessels, ducts, etc.) in
depth. They can be
straight and curved.

111
Shears It is used to cut plaster
“'ra 1 and A
> HEMOSTASIS INSTRUMENTS:
• They are used to temporarily occlude bleeding vessels.
• allow a clearer view of the operating field
• They are pressure clamps: a zipper closure system
• They consist of a groove that compresses the vessels better.

IMAGE NAME USE

Compression of blood
vessels
Pean clamp
ummm—_ — _ - They may or may not
be self-retaining,
—-g O
Compression of blood
vessels

They may or may not

be self-retaining,
“And so

Kocher tongs
They can be straight
or
curves

ar N Compression of blood
vessels

Kocher mouse- They may or may not

be self-retaining,
toothed
tweezers They can be straight
or
// N curves

--either Compression of blood

vessels
X ) ümuuumumm 6 —

They may or may not

Mosquito tweezers
be self-retaining,
(small Kocher
tweezers) They can be straight
or
curves
*TTnnr—my/ill

—D
Compression of blood
vessels

They may or may not

be self-retaining,
Mosquito
forceps with They can be straight
mouse teeth or
"

(small Kocher curves

forceps)
)

Compression of blood
vessels

They may or may not

be self-retaining,

/ Crile forceps
They can be straight
or
curves
You may have mouse
teeth

OTHER CLAMPS
Compression of blood
vessels

They may or may not

be self-retaining,
Rochester
1
forceps They can be straight
or
curves
You may have mouse
teeth
Compression of blood
vessels
——Eg
They may or may not
collin be self-retaining,
tweezers They can be straight
or
curves
 Compression of blood
vessels

8—=
They may or may not
Mouse- be self-retaining,
toothed collin
They can be straight or
forceps curves
You may have mouse
teeth

Compression of blood
vessels

They may or may not

be self-retaining.
Bengolea
They can be straight or
tweezers curves

You may have mouse

teeth

Compression of blood
Kelly forceps vessels May or may
not be self-retaining.

1 0o
(similar to
crille forceps) They can be straight or
curved.

You may have mouse

teeth

Half of its branch has

transverse grooves

Other forceps designed to compress medium and large caliber vessels, which
produce transient ischemia
q"A

compress medium and

Bulldog large caliber vessels,
g

tweezers which produce

transient ischemia
 compress
medium and large
caliber vessels,
which produce
transient ischemia

Declamp
pliers

> Exposure
instruments:
used to free the operating field and facilitate surgical maneuvers for the surgeon.
They allow tissues to be exposed to analyze anatomical structures

3
Separate the tissues
Farabeuf separator Clear the operating
field

!
Separate the tissues
Roux-en-Y separator Clear the operating
field

r11।
ihp medeg-p

1 aMa
0 0
17 . w Separate the tissues

"7 Volkmann separator Clear the operating

field

$$
or OR 7 7
Separate the tissues
Self-static abdominal
or gosset separator Clear the operating
field

Yo or
 Abdominal valve of Separate the tissues
Give
Clear the operating
Manual traction valve field

d mo Separate the tissues

Finochietto
separator Clear the operating
* field

Weitlaner separator Separate the tissues

Clear the operating

field

adson autostatic
Separate the tissues
separator
and /N, 0 Clear the operating
field

Separate the tissues

Carl Martin
Separator Clear the operating
field
______________)
Kocher separator Separate the tissues

c=o—e Clear the operating

field
> DISSECTION INSTRUMENTS: Used to hold tissues to analyze anatomical structures.

—=
Straight
dissecting
forceps Allows to analyze
without anatomical structures
teeth
(anatomical)

—" 7
Straight
dissecting

teeth
(surgical)
Allows to analyze
forceps with anatomical structures

Allows to analyze
Angled anatomical structures
\\
NN
/ \\ \(

dissecting
forceps

-xxuzz-:---------- -------~ * 1 ' * ' Bayonet

Allows to analyze
dissecting anatomical structures
forceps

Clamp
Allows to analyze
Adson anatomical structures
toothless

Clamp
—“l IILm#—- Allows to analyze
Adson with anatomical structures
teeth
ww=WwL
Merian Allows to analyze
Tweezers anatomical structures
 Curved
dissecting
Allows to analyze
forceps with anatomical structures
and without
teeth

\
Straight
To perform biopsies
and curved and punctures
trocar

Buttoned
To explore a wound,
- probe or fistula, ducts…
stylet

_■ ------------------ -
Fluted Facilitates liquid
probe drainage

> GRIP INSTRUMENT: used to hold or assist tissues, adapting to their thickness and resistance

It is used to measure the

OLO

thickness and strength of

fabrics.
Allis clamp
9:5 J st
F

1-_

Clamp of
It is used to measure the
Forester
0.0

thickness and strength of

or

Cotton pad
V

fabrics.
holder
0

Duval-
An

Collin It is used to measure the

Al

thickness and strength of

clamp fabrics.
d
 It is used to stick
Tongue- the tongue out of the
puller mouth.

• SUTURE OR SYNTHESIS INSTRUMENTS: used to join and restore the continuity of tissues
(
((((
th
1

fai Suture straight lines and large and

needles small curves

/ Bk ( N1 n I a 1 Suture Non-absorbable (silk, linen,

//\ HI 1 1 1 threads metal) for internal tissues.
/ ( V/ \ 1 miHIm 1'7 ■ ■■■ i
Absorbable (catgut,
acid, polyglycolic) body
surface

Mayo-Hegar It has an adjustment

_ —^¡i Needle Holder zipper

Mathiew
It is held with the palm of
M Needle the hand
Holder

Littaver They are used to remove

the suture threads.
^2^ scissors
 They allow the placement of

A5ummm and Suture

stapler
metal staples or sutures

They can be disposable or

reusable, dermal or internal.

It causes pressure in the

staple
PP remover
central area of the staple,
opening it.

Reverdin
needles with
handle

Michel's
tweezers

> ASPIRATORS: They are used to keep the operating field free of blood serous matter.
It connects to portable electric suction or vacuum equipment, or to the central vacuum
system.

\ Yankauer vacuum
cleaner
W\
“e

Dermal stapler and

staple remover
w
1
4. THE PRIESTS' CAR

• Transport system for the usual treatment material, used in hospitalization services
• It is a portable metal element that consists of wheels for movement and two trays; it can
also have drawers and a container for a dirty bag.
• It is usually used to treat wounds in the hospital ward.
• For transporting equipment or materials for other procedures such as: catheterization,
intravenous catheterization, etc.

• The wound cleaning and care protocol is usually performed starting with the cleanest
dressing in the room and ending with the dirtiest dressing.
• Its replacement and cleaning are the responsibility of the nursing technician.
• Cleaning will be done daily, emptying and cleaning it with a suitable disinfectant and drying
it afterwards (do not damage the material)

• The material is ordered as follows:

Upper tray Drawers
• Sutures (silk suturing). • Commonly used medications or
• Sterile gloves. ointments.
• Sterile gauze (in individual • IV catheters.
packages). • Connections of equipment or
• Containers with the antiseptics systems.
used.
• Dressings of different types (self-
adhesive or not; hydrocolloids,
hydrogels, etc.), moist or Bottom tray
impregnated (with a fatty • Sterile compress packets.
substance, antibiotic, healing • Sterile surgical drapes or fields.
agent, antiseptic, etc.). • Tubular mesh (for holding dressings)
• Cling film spray (to isolate the of different widths.
wound).
• Bandages of different widths and types
• Adhesive tapes of different widths
and types: cloth, paper or (edged gauze, elastic, etc.).
hypoallergenic. • Cotton.
• Bat(s). • Sterile and disposable syringes of
• Boxes of cures (includes dissection different capacities (5, 10, 20, 50 ml).
forceps, Pean or Kocher forceps, • IM and IV needles of different gauge.
Mayo scissors, grooved probe or • Saline or physiological serum.
stylet). • Serum perfusion systems.
• Non-sterile gloves.
• Upper tray:
■ Boxes of
cures
■ Sutures
■ Sterile gloves
■ Containers with antiseptics
■ Dressings of different types
■ Cling film sprayer
■ Adhesive tapes
■ Bateas
•Drawers:
■ Medicines or ointments
■ Intravenous catheters
■ Equipment or system connections
•Lower tray:
■ Sterile compress packs
■ Surgical drapes or fields
 ■ Tubular mesh
■ Bandages
■ Cotton
■ Sterile and disposable syringes
■ Needles of different gauges
■ Serum (saline and physiological)
■ Serum perfusion system
■ Non-sterile gloves
• Sometimes a list is included with everything that the work cart usually contains.
• It should be replaced every time it is cleaned (at least once a day)
• It is usually kept in the nursing control or treatment room.