Tying gowns after the spin card has dropped

#1rnstudent · Mar 2, 2009

If it drops down and I am unsterile, then I grab the bottom-most tip of the tie and grab it very tightly, then the sterile person grabs a good portion at their end, which is still considered sterile. They spin and then we pull HARD. Since they are disposable gowns at my facility, the material snaps and the gowned person can then tie themselves up.

core0 · Mar 2, 2009

Occasionally when a scrub tech dons a disposable gown, the spin card drops down. In this situation, most circulators do the tying and then cut the excess with a scissor.
This seems kinda sloppy to me though. Since the knot is now contaminated, it is very easy for the scrub tech to contaminate her elbow by touching it to the contaminated knot.
Opinions?

I've never seen this. What I've had happen is the scrub hands the end to the circulator and then the circulator ties it behind the scrub so the knot is directly behind. It leaves the gown a little looser because you don't have as much of the tie crossing but its perfectly functional. For disposable just do the He-man/She-rah pull and take the gown off at the end.

David Carpenter, PA-C

maeyken · Mar 5, 2009

What I've had happen is the scrub hands the end to the circulator and then the circulator ties it behind the scrub so the knot is directly behind. It leaves the gown a little looser because you don't have as much of the tie crossing but its perfectly functional.

That's what we do too. The knot is behind your back which is not sterile anyway. I try to tie up the excess in the knot so that it's not flying around.

Fun2, BSN, RN · Mar 7, 2009

If this happens, I tie the knot in the back of the gown.

I guess, if you really wanted to be on the safe side, you could put on sterile gloves to tie the knot, but the scrub/surgeon should not allow their backs to touch anything.

$fracturenurse$ · Mar 7, 2009

I've never seen this. What I've had happen is the scrub hands the end to the circulator and then the circulator ties it behind the scrub so the knot is directly behind. It leaves the gown a little looser because you don't have as much of the tie crossing but its perfectly functional. For disposable just do the He-man/She-rah pull and take the gown off at the end.
This is my practice as well. The back of the gown is not sterile...

$fracturenurse$ · Mar 7, 2009

I've never seen this. What I've had happen is the scrub hands the end to the circulator and then the circulator ties it behind the scrub so the knot is directly behind. It leaves the gown a little looser because you don't have as much of the tie crossing but its perfectly functional. For disposable just do the He-man/She-rah pull and take the gown off at the end.
David Carpenter, PA-C

This is my practice as well...

mcmike55 · Mar 9, 2009

I'm along the same lines as you all.

I typically take the ties and tie them behind the back, typically in an area that won't endanger the field.

I try to tug the bottom of the gown, folding over the outside edge over the contaminated knot.

That seems to hold our diposable gowns,,,,I agree by the book, the back is contaminated anywho.

If I'm really worried,,,,,drop the gown and start over I guess.

Mike

buck70 · Mar 21, 2009

I totally agree. I ask the tech to cut the strings close to their gown, and then I tape the gown closed by taping it really low in the back. Like really low.................................

buck70 · Mar 21, 2009

I tried to edit my post. I agree with Linda 2097 (the poster). The gowns were not designed for the circulator to tie them. There is still a potential that exists, for contamination, even if the circulator ties it "in the back." Scrubs sometimes move around a lot, and you can't be sure what their back touches and what it doesn't.............................

linda2097 · Mar 22, 2009

I tried to edit my post. I agree with Linda 2097 (the poster). The gowns were not designed for the circulator to tie them. There is still a potential that exists, for contamination, even if the circulator ties it "in the back." Scrubs sometimes move around a lot, and you can't be sure what their back touches and what it doesn't.............................

So your facility's policy is to replace the gown if the card drops?

ShariDCST · Mar 22, 2009

i tried to edit my post. i agree with linda 2097 (the poster). the gowns were not designed for the circulator to tie them. there is still a potential that exists, for contamination, even if the circulator ties it "in the back." scrubs sometimes move around a lot, and you can't be sure what their back touches and what it doesn't.............................

backs of gowns are never considered sterile anyway, so it shouldn't make any difference as far as that's concerned.