Surgical First Assistant

Overview

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The Surgical Assistant/First Assistant is responsible for assisting the surgeon under direct and indirect supervision throughout preoperative, intraoperative, and post-operative duties and procedures as needed. The surgical assistant/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.

The preoperative phase includes, but is not limited to: safe positioning, assist circulator and anesthesia provider in preparation of the patient.

The intraoperative phase includes, but not limited to: performing specific tasks according to individual surgeon preference utilizing appropriate techniques.

The postoperative phase includes, but not limited to: application of specific dressing material, assist in transfer of patient and following patient to recovery if needed or directed by surgeon.

Providing visualization of the operative site by the following, but not limited to:

• 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 surgeons view.
• 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 subcutaneous sutures with absorbable or non-absorbable material.
• Utilizing subcuticular closure technique with or without adhesive skin closure strips.
• Closing skin with method indicated by surgeon (suture, staples, etc.).
• Postoperative subcutaneous injection of local anesthetic agent as directed by the surgeon.
• Selecting and applying appropriate wound dressing: liquid or spray occlusive materials, absorbent material affixed with tape of circumferential wrapping; immobilizing dressing (soft or rigid).
• Familiar with common positions related to the procedure and will be able to use the equipment necessary to provide the position:
  Fracture tables, Head stabilizers, Body stabilizer, C-arm extensions, and 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 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. Nerve damage shall be guarded against.

• Certification from surgical assisting programs accredited through ARC/STSA, ABSA, NSAA.
• 2 years of surgical assistant/first assistant experience is required.
• Some areas may require specialized experience. (i.e. in cardiothoracic surgery, two years of directly related experience is required).

Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and…