Surgical assistant

Occupational description
As defined by the American College of Surgeons, the surgical 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 surgical assistant also performs preoperative and postoperative duties to better facilitate proper patient care. The surgical assistant to the surgeon during the operation does so under the direction and supervision of that surgeon and in accordance with hospital policy and appropriate laws and regulations.

Job description
In general, surgical assistants have the following responsibilities:

• Determine specific equipment needed per procedure
• Review permit to confirm procedure and special needs
• Select and place of x-rays for reference
• Assist in moving and positioning of patient
• Insert and remove Foley urinary bladder catheter
• Place pneumatic tourniquet
• Confirm procedure with surgeon
• Drape patient within surgeon’s guidelines
• Provide retraction of tissue and organs for optimal visualization with regard to tissue type and appropriate retraction instrument and/or technique
• Assist in maintaining hemostasis by direct pressure, use and application of appropriate surgical instrument for the task, placement of ties, placement of suture ligatures, application of chemical hemostatic agents, or other measures as directed by the surgeon
• Use electrocautery mono- and bi-polar
• Clamp, ligate, and cut tissue per surgeon’s directive
• Harvest saphenous vein, including skin incision, per surgeon’s directive
• Dissect common femoral artery and bifurcate per surgeon’s ­directive
• Maintain integrity of sterile field
• Close all wound layers (facia, subcutaneous and skin) as per surgeon’s directive
• Insert drainage tubes per surgeon’s directive
• Select and apply wound dressings
• Assist with resuscitation of patient during cardiac arrest or other life-threatening events in the operating room
• Perform any other duties or procedures incident to the surgical procedure deemed necessary and as directed by the surgeon

Employment characteristics
Certified surgical assistants assist in a variety of surgery specialties:

• General surgery
• Orthopaedic surgery
• Neurosurgery
• Spinal surgery
• Otolaryngology
• Obstetrical surgery
• Gynecological surgery
• Craniofacial surgery
• Radial neck surgery
• Genitourinary surgery
• Cardiac surgery
• Thoracic surgery
• Vascular surgery
• Trauma surgery
• Plastic surgery
• Ophthalmologic surgery

Educational programs
Length. Current CAAHEP-accredited programs range from 10 months to 22 months. Surgical assisting is a specialty profession that requires specific training over and above a degree in science, nursing, physician assisting, or another health profession.
Prerequisites. Recommended eligibility requirements for admission into a surgical assisting program are:

• Bachelor of Science degree (or higher)
• Associate degree in an allied health field, with 3 years of recent experience
• CST, CNOR, or PA-C, with current certification
• Three years of current operating room scrub and/or assisting experience within the last 5 years
• Military medical training with surgical assistant experience
• Proof of liability insurance
• Current CPR/BLS certification
• Acceptable health and immunization records
• Computer literacy

Students also must be able to show proof of successful completion of basic science (college level) instruction, including:

• Microbiology
• Pathophysiology
• Pharmacology
• Anatomy and physiology
• Medical terminology

Curriculum. Course content includes:

• Advanced surgical anatomy
• Surgical microbiology
• Surgical pharmacology
• Anesthesia methods and agents
• Bioscience
• Ethical and legal considerations
• Fundamental technical skills
• Complications during surgery
• Interpersonal skills
• Clinical application of computers

Students must possess a working knowledge of operating room fundamentals, including aseptic principles and techniques, before moving on to the advanced levels of the program.

Credentialing
The National Board for Surgical Technology and Surgical Assisting (formerly Liaison Council on Certification for the Surgical Technologist) offers the Certified First Assistant (CST/CFA) credential, and the National Surgical Assistant Association (NSAA) offers a Certified Surgical Assistant (CSA) credential. To be eligible for NBSTSA testing, individuals must be graduates of a CAAHEP- accredited surgical assistant program or a CST with current certification who meets a number of other eligibility requirements.

Inquiries

Careers/curriculum
National Surgical Assistant Association
2615 Amesbury Road
Winston Salem, NC 27103
(888) 633-0479

Certification
Liaison Council on Certification for the Surgical Technologist
6 West Dry Creek Circle
Littleton, CO 80120
(800) 707-0057
(303)325-2536 Fax

National Surgical Assistant Association
2615 Amesbury Road
Winston Salem, NC 27103
(888) 633-0479

Program accreditation
Commission on Accreditation of Allied Health Education Programs (CAAHEP) in collaboration with:
Subcommittee on Accreditation for Surgical Assisting
6 West Dry Creek Circle, Suite 210
Littleton, CO 80120
(303) 694-9262
(303) 741-3655 Fax
E-mail: ccollinsworth@ast.org