Retraction & Fatigue
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- Опубліковано 19 чер 2024
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As a CSFA, ( been in the OR over 30 years) one of the biggest challenges today is that surgeons make very small incisions. You have to retract harder in order for them to get adequate exposure. This is harder for the assistant and harder on the tissue. Sometimes this stronger retraction causes more noticeable post op pain for the patient so we need to be mindful of that. Sometimes it’s a fine line. P.S. love your videos, keep them coming!
Yes I support Ur explaination
Some tips I share in the OR for Med students:
1. Try to use larger, postural muscles to provide most of the retraction force (eg pull with bicep over wrist extensors, or pull with back over bicep, or grip as neutral as possible, and lean back with your body so that you are pulling with your lower body)
2. Place the retractor in the most proximal portion of your hand. Hold it in your palm is best, better in the metacarpal-phalange, worse in the DIP
3. Place your body and posture in the most relaxed,neutral position as possible. Avoid leaning, bending, twisting, overreaching etc.
4. Use the minimal force possible. Use enough force to retract without tensioning the tissue, so that you only need to overcome gravity instead of the tissue tensile strength.
5. Try to position each joint in mid range of motion (eg elbow approx 90 deg, wrist neutral, etc). Muscles are weaker and have less endurance at end ROM.
6. Alternate the hand applying retraction. Just like you shift from foot to foot when standing. You can also switch grips as needed. Switch at 50% to 80% fatigue. You will recover faster than if you push through the burn.
7. Stay active and stay in shape. You can only pull with the strength and endurance that you train and maintain.
Glad you’re back man. Can you make a video on the instruments used in ortho cases and certain ppe that may be required?
Happy Father’s Day! 😂👍🏻
Love the realness of these videos. Fatigue. Definity have to warm up before surgery. I started to use a (medium tension) band for my shoulders before surgery and noticed improvement in my physical performance during the case. Be careful not to warm-up too much, made that mistake. Keep it light. Also, I use the band through the week.
Hi Shane, hope you had a great Father's Day! Great to see a new video! Thanks for all your time and effort!👍
Going to start my first week soon. These videos from a experienced and knowledgeable tech have been a jump start. Keep them coming and thanks for sharing.
It's great to see such a specific subject. These videos have a whole new value for me now that I've just graduated. Start new job tomorrow! Thanks so much for the uploads and happy Father's day!
Lauren Boada Congratulations 🎊! I hope you have a great first day!
Hi Lauren, I came across your comment. I was curious about your experience as a ST? I hope hope your thriving in the field...
Loosen up and move, I switch hands, switch positions I have done some big open/vascular cases for the past six years and now I am starting new in the cardiovascular center at the University of Michigan....I'm so freaking excited. Love this career. If you work at a teaching hospital it's usually the medical students holding retractors though. Thank you for your time. I wish I had the courage to do UA-cam.
Goodluck on your new venture! I love assisting in CV. Will you be learning how to endo vein harvest?
@@SurgicalTechTipsalready did those when I was on the vascular team at my other hospital. Thank you.
Hi Beth, I looking into becoming a ST. I know you made your comment over a year ago. However, you should make videos about your experiences. They would truly be helpful for many people such as myself. That’s only if you have the time.
Hello Shane glad you’re back
Helpful for us. Thanks for your advice.
I am a student in Connecticut and totally enjoy your videos Shane. Keep it going Sir.
Really ....? are u the student of Shane Freedman?
Thanks Shane! Happy Father’s Day!!!
Love your vids. Would u please do more videos on the Surgical assistant duties and responsibilities. Thanks
Very helpful
Thank you very much sir! Its very helpful for medical students-surgeons
thank you❤️
Just finished my first week of school! Love it already! These videos have been super helpful! Thanks for amazing content Shane!!
Jenn McG how is school? Is it hard? I’m interested in going but I’m nervous lol
@@katemunoz3016 I just started this week!
Just started clinics, this was very helpful! Thank you 😊
Good luck on your clinics and trust me since you are a student they will make you retract for sure. Best advice is keep your eyes and ears open the good thing about retracting is that you are very close to the field watch the surgeon routine. Also, try to watch the tech and see what he/she does and how he/she does things and prepares things
Ugh - I don't want those anywhere near my abdominal cavity
Good work 👍
Can you do a video about what happens with tissue, organs, amputations, etc, that are removed in surgery?
great video, i'm a PA in the OR, I use the elbow tuck technique a lot, also just adjusting my feet, stance, posture can help
Can you elaborate please
@@drmehnazrashid7361 when holding a retractor often the first muscle group to fail for me is my deltoid, so instead of keeping your elbow extended and using your shoulder you just bend at the elbow and adjust your body to use your biceps which can last much longer
Love the content . No pressure but 6 more (1 ea. Month) before 2020
Love your vids as a tech of 11 years its nice to see tips and relevant topics! I'd love to know/see if you have any tips or steps with manipulating a uterus for davinci cases..and delivering the uterus. At my facility we use the v-care, rumi, Pelosi and sometimes the wolf (acorn) thanks! Have a techy day!
Nice
Can u do video on perfusion assembling provesure please and more about perfusion job
The best advice that I got from a surgeon is to use your body weight and retract, especially when you're retracting the abdominal cavity :)
Can you make a video on how to use different types of self retaining surgical retractors?
I've made one on the bookwalter thus far! ua-cam.com/video/6dS-1mjPShA/v-deo.html
6:08 facts I literally go full anime with concentration breathing when I’m holding retraction lol…shout out to Tanjiro from Demon Slayer
Vag hyster’s and radical prostatectomies are the worst to retract for😅 I always have noodle arms after those cases.
In the hospital setting are there certain specialties to go into as a surgical tech such as labor&delivery, general surgery, ortho, etc? Or is it all bunched together?
Jazmin Ibison It varies by hospital. In some facilities, usually smaller ones, it is all bunched together. Some of the larger facilities will assign a tech to one or two specialties, but you are still expected to be able to scrub anything if you are called in for an emergency.
Could you do a video on the difference between getting your certification in surgical tech vs an associates degree? Is there a difference in the duties or pay ?
No difference currently. Not even a pay difference.
No difference same pay
Does a surgical technologist do retraction or just the surgical assistant?
When will you do another QA
Do you have an email I can reach you at??? I have a few questions I would like to ask . Thanks
What about pathology?
Proper way to donning and doffing of PPE
Make a video
Love from india
Are there any benefits in what I can do as first assistant in California? I was wondering if I have to become an RN/PA to do more things like suturing in California? I am currently getting close to finishing my Sterile processing course and wanted to further my education. I would love to be a scrub tech but want to do extra things like suturing and cauterizing or something similar. Any help or advice would greatly be appreciated.
Nick First assist does not exist in California unfortunately
@@talargeloyan2760 Wow so I guess I'm going to go with getting my scrub tech certification. Possibly later if I feel up to it get a ADN or BSN but still deciding.
Yeah california is pretty deeply rooted in with nurses, and AORN. AST has tried to pass a CSFA bill in california for years, but the nurses keep shutting it down. You have to be a PA, NP, or RNFA to assist in CA.
I’m an LPN and I don’t know if I should go into the surgical technologist program or the RN program 🤦🏽♀️
RN, then you can work in other field if you get bored of being a surgical nurse.
Go to L&D, they can train you to scrub as an LPN, OTJ
Saaaaame
👌👌👌👌
I don’t Rembrandt a single thing with all the orthopedic surgeries that I have had done
My name is kelly
Doctor...Ur name please 😣
By watching your videos I came to know that you are a cardiologist ..
But still I'm unable to know your name. You just please reveal it soon and I hope to get a reply from you.
@Lindsay Bates yes i came to know his name as "Shane Freedman" just a few days before. Anyways thanks for ur response
You are wonderful. ALLAH bless you .
You are so cute I would be in OR with you anytime 🤭
First
No need anymore to be a retractor holding machine in ortho. The Gripper is what you need to spend your time doing more valuable stuff. Thank me later.