1. By : Kareem Hamimy
6th year Medical Student
Kasr Al Ainy Faculty of Medicine
Cairo University

2.  This ppt is designed to give a simple tips for
Surgery Interns, observers, Medical students
About observation in OR ( Operation Room )

3.  I would like to thank everyone who gave me
he opportunity to attend and assist in
Surgical operations in Kasr Al Aini
(Professors, Lecturers, Residents, Nurses,
Workers, patients )

5.  1st : Check The Surgery unit that you are going
to attend with.
 2nd : Introduce yourself to the Resident, and ask
him for the permission to attend.
 3rd : Know the schedule of unit .
 ( when is the grand round, when are the operations ? )
 4th : The day before operation, get the List of
patients who are going to OR ).
 5th : Try to take a brief History and full
Examination to these patients.

6.  6th : Try to read about this Disease,
Management, Operative technique, the Night
before the Operations, for Maximum benefit

9.  In Kasr Al Ainy, Scrubs
are not provided in OR
 So Don't forget to pack
your bag with your
clean ironed scrubs.

10.  Before Exiting
lockers you have to
check that you
didn’t miss wearing
any of these :
 Scrubs
 Overshoes or /
Surgical Clogs
 Overhead
 Mask

12.  In The OR, You have to be
 Away from Aseptic Field 50 cm
 Away from the operation table
 Away from The Surgical instruments table
 Away from scrubbed surgeons
 Away from Anesthesia field
 Away from troubles
 Don't ask a surgeon when he is nervous, or when
there is complete silence as this is an indicator of a
precise part of operations which needs ultimate
concentration

13.  While observing, you have to be sure that you
know
 Diagnosis
 Decision ( & why )
 and try to correlate what you read before
with what you are observing

14. A List of what to observe

15.  Type ( Spinal, Regional, Epidural, General)
 Technique
 Intubation ( how ? )
 Cannulation ( IV cannula, Central line )
 Medications used, Dosage
 Monitor

16.  Position of the Patient ( Supine, Prone, Hand
Extended, Elevated, Lithotomy )
 Exposure
 Antiseptic application
 Borders, one way strokes
 Surgical Sheets ( how they are applied ? )
 Light ( Direction ? )

18.  Incision
 Extensions
 When to extend it ? ( Observe when is this
decision taken )
 Layers ( what are the layers incised ? )

20.  Traction and Counter Traction
 Surgical Instruements used
 And why this specific instruement not the other ?

22.  Important Structures ( Anatomy ? )
 Dangerous Areas

25.  Drainage
 Why
 Type ( Suction, …)
 Size
 Position
 How ?

27.  Layers Sutured
 Muscle
 Subcutaneous
 Skin

28.  How? ( Simple, Subcuticular ), and ask the
resident to show you how is it done
 Material ( proline, Vicryl, silk )
 When? ( ask when to use different types, and
size ? )
 And why ?

29.  Betadine
 Dressing
 Plaster

30.  Waking the patient ( anaesthesia )
 Postoperative care
 Visiting patient, the next day of operation is
essential, try to follow to observe Recovery
phase, and if complications occurred, and
how to manage

31.  After being Familiar, with the OR, and the
operations,
 You can ask the resident, to scrub in for
assistance and better observation

32.  Prof Dr Aly Haseeb : Illustrated Operative
Surgery.
 Browse Symptoms and Signs of Surgical
diseases.
 Oxford Handbook of Clinical Surgery.
 Basic Surgical Techniques ( R M Kirk ).
 Essential General Surgical Operations ( R M
Kirk ).

33. Thank You
For Comments and Further info :
Kareemhamimy89@yahoo.co.uk