Surgical First Assist

Under the Perioperative leader, assumes responsibility and accountability for assuring quality care as a health care team member within the Perioperative environment. The scope of responsibility of the Certified Surgical First Assistant includes the ability to anticipate, plan for, and respond to the needs of the patient, surgeon, and other team members. In addition, the CSFA participates in and actively assists the surgeon in completing the operation safely and expeditiously by helping to provide exposure, maintain hemostasis, and other technical functions. This non-exempt position reports to the Director Surgery and is part of Surgical operations.

QUALIFICATIONS

Education

• High school diploma or the equivalent GED
• Graduate from a surgical assisting program accredited through ARC/STSA, a collaborative effort of ASA, ACS, and SASA, by CAAHEP. CAAHEP is a recognized accreditation agency of the Council for Higher Education Accreditation (CHEA).

Experience/Skills

• 2 years of surgical technician experience with additional experience as Certified Surgical First Assistant (CSFA)
• Excellent verbal and written communication skills
• Demonstrates a working knowledge of general computer skills and applications
• Knowledge of specialized first assistant techniques, procedures and adequate equipment related to hemostasis, retracting and suturing skills
• Self-motivated
• Ability to work effectively in collaboration with others
• Ability to multitask
• Adaptable

Required Licenses/Certifications

• Must have certification as an Operating Room Technician/First Assistant
• CPR

Working Conditions

• Clean, well-lighted working environment
• Occupational exposure

ROUTINE RESPONSIBILITIES

Positioning the Patient

• The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will collaborate with the RN Circulator to carry out the order with consideration 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
• 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
• Familiar with common position related to the surgical procedure and will be able to use the equipment necessary to provide the position. Competencies will include the following: fracture tables; head stabilizers; body stabilizers; C-arm extensions; any other equipment needed
• 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.

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)

Utilizing Appropriate Techniques to Assist with Hemostasis

• Permanent: clamping and/or cauterizing vessels or tissue; tying and/or ligating clamped vessels or tissue; applying hemostatic clips; placing local hemostatic agents
• Temporary: applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use; applying vessel loops; applying non crushing clamps; applying direct digital pressure

Utilizing Appropriate Techniques to Assist with Closure of Body Planes

• 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

Selecting and Applying Appropriate Wound Dressings

• Liquid or spray occlusive materials
• Absorbent material affixed with tape or circumferential wrapping
• Immobilizing dressing (soft or rigid)
• Provides assistance in securing drainage systems to tissue