What do I do with my (sterile) hands (in the OR)?!

2 minute read

Introduction

Ricky Bobby said it best, “I don’t know what to do with my hands!”. As a student scrubbed into a surgery, you feel like the pressure is on to keep from contaminating yourself. Here are some tips concerning what to do with your hands while you are scrubbed in so you come to the OR prepared and ready to help.

First lets cover where not to put your hands

On the patient’s face. This sounds silly but sometimes you lose track of this stuff when all the drapes are placed and the operation is near the patient’s head. This rule also applies to other sensitive areas of the patient’s body.
On the scrub tech’s mayo stand. The number one reason not to do this is safety. Sharp instruments are constantly being picked up and put down on this table, and the tech is keeping them organized in order to prevent sticking themselves. It is best to steer clear of this table in order to keep both you and the tech safe. If you have a rapport with the tech, you can ask to pick something off the mayo stand if needed.
Below your belly button (or the table), in your armpits or above your xyphoid process. Remember that the sterile field only extends to your front side, from nipples to belly button, and your arms, excluding your armpits. You may see attendings or residents stick their hands in their armpits while they wait for something, but as a student it is best to be safe as this practice is generally frowned upon.

Where you should put your hands

you should be able to rest your hands gently near the sterile field. They should be out of the way but close enough so that you can act quickly if an extra set of hands are needed. This is an art form and takes time to perfect.
Across the top of your stomach. If you are away for the table for whatever reason, you should place your hands on the top of your stomach so it is clear you will not accidentally contaminate yourself.
You and your hands should try to anticipate things that are asked of you as a student. Being prepared with a pair of suture scissors in your hand when someone is tying a knot is a great example.

If you are not sure

Do not hesitate to ask the scrub tech if you are unsure how to best keep your hands sterile during a surgery. They would rather give you tips than help you re-scrub. At some point we were all Ricky Bobby before.