Surgical Tech - First Asst - Per Diem

Position Summary:

Surgical assistants provide 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 surgical assistant also performs preoperative and postoperative duties to better facilitate proper patient care. The surgical 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.

Education, License & Cert:

Surgical assistants graduate from surgical assisting programs accredited through ARC/STSA, a collaborative effort of AST, ACS, and SASA, by CAAHEP. CAAHEP is a recognized accreditation agency of the Council for Higher Education Accreditation (CHEA). In addition, surgical assisting programs are located in educational institutions that are institutionally accredited by agencies recognized by the United States Department of Education (USDE), The Joint Commission, or a state agency acceptable to CAAHEP and the ARC/STSA. The ARC/STSA is also a member of the Association of Specialized and Professional Accreditors (ASPA).

Certification is conferred by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). Currently, initial certification as a Certified Surgical First Assistant (CSFA) is based upon graduation from a CAAHEP-accredited school of surgical assisting followed by satisfactory performance on the national Certified Surgical First Assistant examination. CSFAs maintain their certification by earning approved continuing education or by successfully retaking the certifying examination at the conclusion of the renewal period. Any other circumstances or previously accepted pathway to an accredited certification such as on-the-job training who continued to maintained their accredited credential remain in good standing.

Experience:

Experience preferred.

Essential Functions:

1. 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. 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.
2. 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
3. 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 noncrushing clamps
     • Applying direct digital pressure
4. Participating in volume replacement or autotransfusion techniques as appropriate.
5. 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
6. Selecting and applying appropriate wound dressings, including the following:
   • Liquid or spray occlusive materials
   • Absorbent material affixed with tape or circumferential wrapping.
   • Immobilizing dressing (soft or rigid)
7. Providing assistance in securing drainage systems to tissue

Other Duties:

1. Demonstrates initiative in completing work that needs to be done, within areas of responsibility.
2. It is understood that this description is not intended to be all‐inclusive, and that other duties may be assigned as necessary in the performance of this position
3. Recognizes and reports potential problems to the supervisor or nursing manager on the floor.