During patient transfer from the OR table to the stretcher, who controls the patient's head and airway?

The anesthesiologist. The anesthesiologist controls the patient's head and airway during ALL transfers and position changes. This is because the airway is the most critical concern — the endotracheal tube, laryngeal mask, or natural airway must be maintained during movement. The anesthesiologist directs the timing of the transfer.

What does the "B" in the SBAR handoff format stand for?

Background. SBAR stands for Situation, Background, Assessment, and Recommendation. The "B" (Background) includes the patient's medical history, allergies, NPO status, and preoperative baseline vitals. SBAR is a standardized communication tool that ensures all critical information is conveyed during patient handoffs.

After a case is completed and the patient has left the OR, the surgical technologist should FIRST:

Don PPE and safely dispose of sharps and biohazardous waste. After the patient leaves, the surgical technologist should don appropriate PPE (new gloves, gown, mask, eye protection) and begin the room breakdown process. Sharps disposal is a priority safety step. All biohazardous waste must be properly disposed of, and reusable instruments must be decontaminated and sent to SPD.

Key Takeaways

The patient is transferred from the OR table to the stretcher or bed with a coordinated team lift
The anesthesiologist controls the head and airway during all patient transfers
Minimum of 4 persons required for patient transfer: anesthesiologist, surgeon or first assist, surgical tech, circulator
IV lines, drains, catheters, and monitoring equipment must be secured and maintained during transfer
The circulating nurse provides a verbal handoff report to the PACU nurse using SBAR format
SBAR stands for Situation, Background, Assessment, Recommendation
Operative documentation includes the surgical count record, specimen documentation, implant records, and any incidents
The surgical technologist assists with room breakdown and turnover for the next case

Patient Transfer & Postoperative Documentation

The postoperative phase continues until the patient is safely transferred to the recovery area and all documentation is complete.

Patient Transfer from OR

Transfer Procedure

Prepare the stretcher: Bring the stretcher to the OR, lock wheels, ensure warm blankets are available
Disconnect and secure: Secure drains, IVs, catheter, and monitoring leads for transport
Coordinate the lift: Minimum 4 persons — the anesthesiologist controls the head and airway
Count to move: "On three, everyone lifts together" — use a slide board or draw sheet
Safety first: Side rails UP, safety straps secured, wheels locked until ready to move
Warm the patient: Apply warm blankets — hypothermia is common after surgery
Transport: Anesthesia team and circulating nurse accompany the patient to PACU

Key Safety Considerations

Never leave a sedated patient unattended on the OR table or stretcher
Drains and catheters should be positioned to maintain gravity flow (below the surgical site)
The Foley catheter bag should hang below the level of the bladder
Monitor the patient's airway, breathing, and circulation during transport

SBAR Handoff Communication

The circulating nurse provides a verbal report to the PACU nurse using the SBAR format:

Element	Content
S — Situation	Patient name, age, procedure performed, surgeon
B — Background	Medical history, allergies, NPO status, preoperative baseline vitals
A — Assessment	Current vital signs, airway status, dressings, drains, estimated blood loss (EBL), fluid intake
R — Recommendation	Pain management plan, activity restrictions, anticipated issues, surgeon orders

Postoperative Documentation

Surgical Technologist Documentation Responsibilities

Surgical count sheet: Final count correct (or incorrect count protocol documented)
Specimen log: All specimens identified, labeled, and sent to appropriate lab
Implant documentation: All implant lot numbers, serial numbers, and expiration dates recorded
Time documentation: Assist with recording incision time, closure time, tourniquet time
Incident reporting: Any breaks in sterile technique, sharps injuries, or equipment malfunctions

Room Turnover (Between Cases)

After the patient leaves the OR:

Don PPE (gown, gloves, mask, eye protection) for terminal cleaning
Dispose of sharps in puncture-resistant containers
Dispose of disposable items (drapes, gowns, sponges) per biohazard waste protocol
Decontaminate reusable instruments — transport to SPD (Sterile Processing Department) in closed, labeled containers
Wipe all surfaces with EPA-approved disinfectant (OR table, Mayo stand, back table, lights, monitors, anesthesia machine)
Mop the floor with disinfectant
Restock supplies for the next case
Set up for the next case — open sterile packs, gown, glove, and organize instruments

Terminal cleaning (end of day) is more extensive — includes walls up to shoulder height, ceiling-mounted equipment, vents, and all furniture.

CST Certified Surgical Technologist Exam

1Introduction: CST Exam Overview

2Chapter 1: Perioperative Care — Preoperative Preparation

3Chapter 2: Perioperative Care — Intraoperative Procedures

4Chapter 3: Postoperative Procedures & Ancillary Duties

5Chapter 4: Basic Science

6Chapter 5: Exam Strategy & Practice