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Surgery
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===Preparing for surgery=== {{More citations needed section|date=January 2019}} A surgical team may include a surgeon, anesthetist, a circulating nurse, and a "scrub tech", or surgical technician, as well as other assistants who provide equipment and supplies as required. While informed consent discussions may be performed in a clinic or acute care setting, the pre-operative holding area is where documentation is reviewed and where family members can also meet the surgical team. Nurses in the preoperative holding area confirm orders and answer additional questions of the family members of the patient prior to surgery. In the pre-operative holding area, the person preparing for surgery changes out of their street clothes and are asked to confirm the details of his or her surgery as previously discussed during the process of informed consent. A set of vital signs are recorded, a peripheral [[intravenous therapy|IV line]] is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given.<ref>{{Cite web|url=https://medlineplus.gov/ency/patientinstructions/000578.htm|title=The day of your surgery β adult: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|access-date=2019-01-24}}</ref> When the patient enters the operating room and is appropriately anesthetized, the team will then position the patient in an appropriate [[Surgical Positions|surgical position]]. If hair is present at the surgical site, it is clipped (instead of shaving). The skin surface within the [[operating field]] is cleansed and prepared by applying an [[antiseptic]] (typically [[chlorhexidine gluconate]] in alcohol, as this is twice as effective as [[povidone-iodine]] at reducing the risk of infection).<ref>{{cite journal | vauthors = Wade RG, Burr NE, McCauley G, Bourke G, Efthimiou O | title = The Comparative Efficacy of Chlorhexidine Gluconate and Povidone-iodine Antiseptics for the Prevention of Infection in Clean Surgery: A Systematic Review and Network Meta-analysis | journal = Annals of Surgery | volume = 274 | issue = 6 | pages = e481βe488 | date = December 2021 | pmid = 32773627 | doi = 10.1097/SLA.0000000000004076 | doi-access = free }}</ref> Sterile drapes are then used to cover the borders of the [[operating field]]. Depending on the type of procedure, the cephalad drapes are secured to a pair of poles near the head of the bed to form an "ether screen", which separate the [[anesthetist]]/[[anesthesiologist]]'s working area (unsterile) from the surgical site (sterile).<ref>{{cite book| vauthors = Martin S |title=Minor Surgical Procedures for Nurses and Allied Healthcare Professionals|date=2007|publisher=John Wiley & Sons, Ltd|location=England|isbn=978-0-470-01990-0|page=122|url=https://books.google.com/books?id=EaDbhAO3kS8C&pg=PA113}}</ref> [[Anesthesia]] is administered to prevent [[pain]] from the trauma of cutting, tissue manipulation, application of thermal energy, and suturing. Depending on the type of operation, anesthesia may be provided [[local anesthesia|locally, regionally]], or as [[general anesthesia]]. [[Spinal anesthesia]] may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the person can remain conscious or minimally sedated. In contrast, general anesthesia may render the person unconscious and paralyzed during surgery. The person is typically [[intubation|intubated]] to protect their airway and placed on a [[mechanical ventilator]], and anesthesia is produced by a combination of injected and inhaled agents. The choice of surgical method and [[anesthesia|anesthetic]] technique aims to solve the indicated problem, minimize the risk of complications, optimize the time needed for recovery, and limit the [[surgical stress]] response.
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