Core Surgical Skills: Basic Instrument Use

Independent Activity 1

Printer-friendly versionObjective:

In this activity, you will practice the proper techniques for arming, disarming, and passing the scalpel.

What you will need:

  • #3 scalpel handle
  • #10 blade
  • Needle holders

Preparation:

Before attempting this activity, thoroughly review the following topics in the Scalpel Module: Arming a Scalpel, Disarming a Scalpel, and Handing Off Scalpels. You might find it helpful to watch the training videos while you practice these skills. When practicing the technique for passing the scalpel, you will need to pair up with an assistant.

  1. Practice arming the scalpel blade
  • To arm a scalpel blade properly, begin by peeling back the package to expose the base of the blade.
  • Once the base of the blade is exposed, orient the angled base toward you and the sharp edge of the blade away from you. Then grasp the spine of the blade in the jaws of the needle holder at a 45–90 degree angle. Being careful not to touch any part of the package's surface, slide the blade out of the package.
  • Make certain that the needle holder is gripping the spine of the blade just above the blade slot. If necessary, reposition the blade in the jaws of the needle holder. This adjustment can be done with your fingers (touching only the spine of the scalpel), but NEVER attempt to arm the scalpel handle with your fingers. Be certain that you do NOT grip the sharpened scalpel edge with the jaws of the needle holder at any point during this procedure; this is unsafe and will dull the cutting edge.
  • Once the spine of the blade is secured properly in the needle holder, align the slot in the angled base of the blade over the blade lock on the scalpel handle. Carefully slide the blade down the track until the slot in the blade snaps into place on the blade lock.
  • While loading the scalpel, if the blade lodges on the blade lock, carefully pull it off with the needle holder. Then reinsert the blade, making sure it slides smoothly within the track of the blade lock.
  1. Practice arming the scalpel blade
  • To disarm, using your non-dominant hand, grasp the surgical scalpel in the center of the handle. Position the blade lock facing upward. With the angled base of the blade facing your hand, orient the cutting edge of the blade away from yourself and others.
  • Use the tips of the needle holder to grip the slanted edge of the blade base. Make certain that you have a firm grasp on the blade base so that the needle holder does not slip off.
  • Carefully lift the blade from the slanted end of the blade lock until the key-like blade slot separates from the handle lock. You might hear a click, and the blade will loosen on the scalpel handle. Push the blade away from yourself and toward the tip of the scalpel handle. If the blade lodges as you try to remove it, you might need to twist or wiggle the blade slightly as you slide it off.
  • Arm and disarm the scalpel blade until you are proficient with these skills.
  1. Practice passing and receiving the scalpel correctly
  • To hand off an armed scalpel, begin by grasping the surgical scalpel in the center of the handle with your dominant hand. Orient the blade facing away from your palm and away from your assistant.
  • Firmly place the scalpel handle in the outstretched hand of your assistant. However, do not immediately withdraw your hand. Once he or she has a firm grasp of the handle, slowly remove your hand.
  • Next, have your assistant pass the scalpel back to you. Hold out your dominant hand, with your palm facing upward.
  • Have your assistant place the scalpel in the palm of your hand. To avoid injury, grasp the scalpel handle and then wait until your assistant's hand is completely withdrawn before you pull the scalpel away.
  • Perform at least 5 correct passes between you and your assistant.