CST Perioperative Patient Advocacy 2 — Questions and Answers
Question 1: A patient tells the scrub tech just before induction that she has not signed the consent form for the planned bilateral procedure, only for the unilateral procedure. What is the most appropriate action?
- Proceed because the surgeon has verbal authorization
- Notify the circulator and surgeon immediately to halt the procedure (Correct answer)
- Document the discrepancy and proceed if the surgeon agrees
- Ask the anesthesiologist to clarify with the patient post-induction
Correct answer: Notify the circulator and surgeon immediately to halt the procedure
The scrub tech must immediately notify the circulator and surgeon so the consent issue is resolved before any incision is made.
Question 2: During the surgical time-out, the circulator reads a different operative site than what is marked on the patient. The surgeon says 'we've done this a hundred times, let's go.' What should the surgical technologist do?
- Defer to the surgeon's experience and proceed
- Silently note the discrepancy in the count record
- Speak up and insist the discrepancy be resolved before proceeding (Correct answer)
- Ask the anesthesiologist to make the final call
Correct answer: Speak up and insist the discrepancy be resolved before proceeding
Every team member has the authority and responsibility to stop the procedure until a site discrepancy is resolved, regardless of the surgeon's preference.
Question 3: A patient's advance directive states 'Do Not Resuscitate.' The anesthesiologist proposes a routine suspension of the DNR during the operative period. Who bears primary responsibility for ensuring this discussion occurs pre-operatively with the patient?
- The surgical technologist during the pre-op assessment
- The surgeon and anesthesiologist in collaboration with the patient (Correct answer)
- The OR charge nurse alone
- The hospital ethics committee
Correct answer: The surgeon and anesthesiologist in collaboration with the patient
The surgeon and anesthesiologist must collaboratively discuss with the patient whether to suspend, modify, or honor the DNR during the perioperative period.
Question 4: While setting up the back table, the scrub tech notices the patient's allergy wristband indicates a latex allergy, but the surgeon's preference card does not specify a latex-free setup. What is the correct action?
- Use standard supplies since the surgeon's card takes precedence
- Notify the circulator immediately and switch to a latex-free environment (Correct answer)
- Remove only the latex gloves and continue with other latex items
- Wait until after the time-out to inform the surgeon
Correct answer: Notify the circulator immediately and switch to a latex-free environment
A documented latex allergy requires an immediate latex-safe environment; the scrub tech must notify the circulator before any latex items contact the patient's care environment.
Question 5: A family member approaches the scrub tech in the hallway and asks for an update on their relative's surgery. What is the appropriate response?
- Provide a brief reassuring status update to ease family anxiety
- Direct the family member to the waiting room liaison or charge nurse (Correct answer)
- Explain that the surgery is progressing without complications
- Share the estimated completion time based on the schedule
Correct answer: Direct the family member to the waiting room liaison or charge nurse
The scrub tech should redirect family members to the designated waiting room liaison or circulating nurse who is authorized to provide updates while maintaining HIPAA compliance.
Question 6: The surgeon requests the scrub tech to document in the operative record that a procedure step was performed, when the scrub tech did not observe it being done. What should the scrub tech do?
- Document as requested because the surgeon has ultimate responsibility
- Refuse to document an event not personally witnessed (Correct answer)
- Ask the circulator to document it instead
- Add a notation that documentation is based on surgeon's verbal report
Correct answer: Refuse to document an event not personally witnessed
A surgical technologist must never document events not personally witnessed, as falsifying medical records is illegal and unethical.
Question 7: During positioning for a prolonged spine case, the scrub tech notices the patient's arm is resting against a metal bed rail without padding. What is the priority action?
- Inform the surgeon after the incision is made
- Alert the circulator before draping so padding can be added (Correct answer)
- Note it in the count sheet as a positioning concern
- Assume the anesthesiologist has already assessed all pressure points
Correct answer: Alert the circulator before draping so padding can be added
The scrub tech should immediately alert the circulator so padding is added before draping, preventing a positioning injury from developing during the prolonged case.
CST Perioperative Patient Advocacy 2
A patient tells the scrub tech just before induction that she has not signed the consent form for the planned bilateral procedure, only for the unilateral procedure.
What is the most appropriate action?