Description:
Position Summary
The Certified Surgical First Assistant provides aid in exposure, hemostasis, closure, and other intraoperative technical functions that help the surgeon carry out a safe operation with optimal results for the patient. In addition to intraoperative duties, the Certified Surgical First Assistant also performs preoperative and postoperative duties to better facilitate proper patient care. The Certified Surgical First Assistant performs these functions during the operation under the direction and supervision of the surgeon and in accordance with hospital policy and appropriate laws and regulations. Responsible for performing a variety of procedures or may specialize in a surgical specialty where appropriate. Performs responsibilities of a Surgical Technologist as needed or required.
Primary Responsibilities
1. Prepare patients for surgery by washing, shaving, and ensuring aseptic incision sites.
2. May transport patients to the operating room, help position them on the operating table, and cover them with sterile surgical drapes.
3. Demonstrate excellent communication skills and collaborate with the surgeons, specialty team members, and other departments.
4. Serve as a resource for staff and other disciplines.
5. Identifies process improvement opportunities and assists in implementation.
6. 3. Utilizing appropriate techniques to assist with hemostasis. Permanent(1) Clamping and/or cauterizing vessels or tissue(2) Tying and/or ligating clamped vessels or tissue(3) Applying hemostatic clips(4) Placing local hemostatic agents.
7. Assume responsibility under the direction of the Clinician for all repairs, ordering, and maintenance of supplies, equipment, lasers, and instrumentation related to the specialty service.
8. Assist the Clinician in supervising the use of supplies and equipment for patient care and safety in all procedures.
9. Competencies will include the following:(1) Fracture tables(2) Head stabilizers(3) Body stabilizers(4) C-arm extensions(5) Any other equipment needed.
10. Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning which will include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out.
11. Support cost containment in the use of materials and equipment.
12. Providing visualization of the operative site by the following: Appropriate placement and securing of retractors with or without padding. Packing with sponges. Digital manipulation of tissue. Suctioning, irrigating, or sponging. Manipulation of suture materials (e.g., loops, tags, running sutures). Proper use of body mechanics to prevent obstruction of the surgeon’s view.
13. Positioning the patient. The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will carry out this order. Consideration will be given to the patient’s comfort and safety. Points of pressure shall be padded: elbows, heels, knees, eyes, face, and axillary region. Circulation shall not be impaired. (A tourniquet may be required for some procedures.) Nerve damage shall be guarded against. The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range. The surgical assistant shall be familiar with common positions related to the surgical procedure and will be able to use the equipment necessary to provide the position.
14. Close all wound layers (fascia, subcutaneous, and skin) as per the surgeon’s directive. Be familiar with different sutures and suturing techniques to provide the desired outcome.
15. Demonstrate initiative in problem-solving as related to patient and technical issues that contribute to the improvement of the Operating Room function and operation.
16. Utilizing running or interrupted sutures with absorbable or nonabsorbable material of wound layers, including muscle and fascia. Utilizing subcuticular closure technique with or without adhesive skin closure strips. Closing skin with method per surgeon’s directive (suture, staples, etc. Postoperative subcutaneous injection of local anesthetic per surgeon’s directive.
17. Temporary(1) Applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use (2) Applying vessel loops (3) Applying noncrushing clamps (4) Applying direct digital pressure.
18. Participating in volume replacement or autotransfusion techniques as appropriate.
19. Utilizing appropriate techniques to assist with the closure of body planes.
20. Selecting and applying appropriate wound dressings, including the following: A. Liquid or spray occlusive materials B. Absorbent material affixed with tape or circumferential wrapping. C. Immobilizing dressing (soft or rigid).
21. Providing assistance in securing drainage systems to tissue.
Competencies
1. Advanced knowledge and skill in major operative surgical specialties performed.
2. Advanced knowledge of anatomy, physiology, and potential complications for procedures performed.
3. Advanced knowledge and skill of aseptic surgical techniques used in the preparation of materials, supplies, and equipment for various surgical procedures and suturing.
Supervisory Responsibility
None.
Requirements:
Required Education and Experience
1. Completion of a formal surgical technician program offered by a community or junior college, vocational school, university, hospital or the military.
2. Graduate of an accredited Surgical First Assist Program
3. Current certification as a Certified First Assist (CFA through the National Board of Surgical Technologist and Surgical Assistants)
4. 3 years of current Operating Room experience preferred
5. Advanced knowledge of at least 2 surgical specialists with 1 year experience in selected specialty desired.
6. Certified Surgical Technician Cert First Assist through NBSTSA or ABSA to be obtained within one year of hire/transfer date.
7. Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR)
8. Certified Surgical Technologists (CST) OR Tech in Surgery-Certified (TSC)
