Stradis Healthcare
Asepsis Training - Operatory Preparation

  1. The circulator (non-sterile assistant) should begin to prepare the operatory while the sterile assistant scrubs. If there is only one assistant, the operatory should be prepped prior to the scrub.

  2. All walls should be wiped down with an antiseptic from 48 inches to the floor. The floor should also be cleaned. If the operatory is exclusive, this can be done the evening before the procedure.

  3. The circulator does the following preparation:

    • Remove all unnecessary items such as plants, cups and personal items.

    • Wipe down all horizontal surfaces with an EPA approved hospital disinfectant including lights, equipment, stands and the chair or table.

    • All necessary supplies should be gathered including the Professional Sterile Systems pack, all sterilized instruments, sterile water and gloves.

    • Open the pack away from the body, being careful to only touch the outer edges and place on a table. Do not touch the sterile contents of the pack or lean over the pack.

      Remember - the circulator should stay at least 12 inches from the sterile field at all times and must not reach across the sterile field for any reason.

    • Carefully add the sterile gloves to the pack by peeling open the pack, again away from the body, and dropping them onto the sterile field.

    • A regular table or tray should be set up for non-sterile items.



  4. The sterile assistant enters the operatory with wet hands after performing the scrub. Using a sterile towel from the opened pack dry hands from the fingertips to the elbow. Reverse towel for the second hand and arm.

  5. The sterile assistant grasps and unfolds the gown from the pack and steps into it with both arms simultaneously, leaving hands within the sleeve. Don't go past the cuff. Remember, your hands are disinfected, not sterile.

  6. The circulator ties the gown from behind at the inner closure and neck.

  7. The sterile assistant puts on the sterile gloves as follows:

    • Open the glove pack with the hands still within the sleeve.

    • Use the cuff of the gown to pull up the cuff of the glove over the cuff of the gown.

    • Extend your hand into the glove.

    • Repeat for the other hand.

      Keep hands at chest level.

  8. The circulator pours sterile water onto a sterile towel, being careful not to touch the towel. The sterile assistant and later the doctor will use this towel to wipe off gloves to remove all powder to avoid contamination of instruments which can affect some procedures.

  9. The circulator assists the sterile assistant in "turning the gown" as follows:

    • The sterile assistant separates the short ties from the card and hands the card to the circulator being careful not to touch the circulator.

    • The sterile assistant turns, wrapping the gown around the body and grasps the tie as the circulator pulls the card away.

    • The sterile assistant ties the gown around the waist.

      The sterile person is considered sterile from the nipple line to the waste level and from the front of the arm to the fingertips. For this reason, the sterile assistant should keep hands above the waist area and below the nipple line.

  10. The sterile assistant completes the operatory prep as follows:

    • Open stand covers and place on the instrument tray or stand.

    • Place a sterile towel on the instrument tray or stand.

    • Tape a suture bag to the side of the instrument tray for refuse such as bloody gauze. After the procedure this can be disposed of in a red hazard bag.

    • Drape all monitoring devices and equipment, even those that might not be used.

    • Apply headrest covers to chair and light handle covers.

    • Place tubing on the suction and water tubes. It is sometimes easier to cover the suction tube if the suction is turned off at the main switch.

  11. Prepare the instruments as follows:

    • The circulator opens the outer wrapper of the sterile instruments.

    • The sterile assistant removes the instruments to the tray, arranging according to use.

      Any item which can not be autoclaved should be sterilized the night before by placing in a glass container with cidex or sponicide following the manufacturer's directions. Because of the risk of seepage, do not soak anesthetic carpules. You can however, spray them down 30 minutes prior to use.

  12. We recommend having two or three extra sets of sterile gloves in case the circulator needs to assist by mixing bone, etc. Extra masks, head covers and shoe covers should also be available in case other persons need to enter the operatory.

    Any persons who enter the operatory during the procedure should wear a mask, head cover and shoe covers.






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