CORE CURRICULUM - PDF document

1 FOURTH EDITION CORE CURRICULUM FOR SU
FOURTH EDITION CORE CURRICULUM FOR SURGICAL ASSISTING – III CORE CURRICULUM FOR SURGICAL ASSISTING, FOURTH EDITIONucation in Surgical Technology and Surgical Assisting Littleton, CO 80120 Association of Surgical Assistants Littleton, CO 80120 Copyright 2020 by the Association of Surgical Assistants/Association of Surgical Technologists, 6 West Dry Creek Circle, Littleton, CO 80120. All rights reserved. Pri

2 nted in the United States of America. No
nted in the United States of America. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, phototherwise, without the prior written permission of the publisher. IV ACKNOWLEDGEMECurriculum for Surgical Assisting of the following surgical assiand surgical assistant practitioners. Jeff Bidwell, CST, CSFA, CSA, MA, FAST; ReT

3 echnology and Surgical Assisting; Surgic
echnology and Surgical Assisting; Surgicalical Assisting Program Director; Stark State R. Clinton Crews, MPH; Surgical Assisting PrJennifer Eanes, CST, CSFA, BS; ASA Education Committee; Practicing CSFA; Panama City, rgical Assisting Program Director; Delta College; University Center, MI T, COA, EdS, FAST; Surgical Assisting Division Chair Surgical Services; Fayetteville Technical Community College; Fayetteville

4 , NC Sarah May, CST, CSFA; ASA Education
, NC Sarah May, CST, CSFA; ASA Education Committee; Practicing CSFA; Powhatan, VA Mary (Libby) McNaron, CST, CSFA, RN, MSN,Director; Gulf Coast State College; Panama City, FL Justine Miraldi, CST, CSFA; ASA Education Committee; Practicing Sara Parks, CST, CSFA; ASA Education Committee; Practicing CSFAal Assisting Program DirectGreg Salmon, CST, CSFA, MBA; Director of Degr Community College; Detroit, MI Dennis S

5 tover, CST, CSA, FAST; Surgical Assistin
tover, CST, CSA, FAST; Surgical Assisting Program Director; Meridian Institute of Surgical Assisting; Nashville, TN DuPage; Glen Ellyn, IL previous editions: , Chair; Rebecca Hall, CST, CSA, Crystal Warner, CST, CSA. ; Diane Gerardot, CST; Chris Keegan, CST, FAST; Stacey May, CST; Kathy Mendoza, Jeff Ware, CST, CSFA. First Edition: James Bell, CST, CSFA; Bob Caruthers, CNOR; Samuel Kalush, MD; Margrethe May, CSa

6 nd Nancy Santaniello, CST, PA-C. VI VI
nd Nancy Santaniello, CST, PA-C. VI VII TABLE OF CONTENTSIntroduction I. Surgical Sciences A. Surgical Anatomy, Physiology, Pathophysiology 4 Common Comorbidities (Diseases, and Disorders)B. Technological Sciences 13 C. Physiological Chemistry: Electrolytes, Fluid and Shock 14 D. Pharmacology and Anesthesia 16 E. Infection Control in the Perioperative Setting 18 F. Hematological Principles of S

7 urgery 21 G. Wound Management 23 H. A
urgery 21 G. Wound Management 23 H. All-Hazards Preparation 27 II. The Surgical Assistant Objectives 29 Surgical Assistant Role 30 Professional Skills 31 sponsibilities 32 Business Practices 34 III. Perioperative Management of the Surgical Patient Preoperative Management 35 Preoperative Surgical Management 36 Preoperative Patient Assessment 37 Preoperative Skills 38 B. Intraoperative Manag

8 ement 41 1. Intraoperative S
ement 41 1. Intraoperative Skills 42 2. Surgical Procedures Didactic 44 Co-Related Surgical Procedures Concept 45 General 46 Obstetric and gynecologic 47 Genitourinary 48 Ophthalmic 49 Otorhinolaryngology 50 Orthopedic 51 Plastic and reconstructive 53 Neurosurgery 54 Cardiothoracic 55 Peripheral vascular 56 Procurement 57 C. Postoperative Management 58 VIII IV. Clinical Requirements

9 V. Required Core Surgical Technology C
V. Required Core Surgical Technology Curriculum* *Required introductory operating room core components for programs that accept those students with no previous operating room experience or See the most recent edition of the AST Core for Required Core Content. 66 Appendix A: ASA Job Description Appendix B: Lab Skills Competencies Appendix C: Program Resources 72 Appendix D: References 73

10 Core Curriculum for Surgical Assisting
Core Curriculum for Surgical Assisting In 1990, the Association of Surgical Technologists (AST) began the process of examining the role at many individuals withingrowth of the profession, AST contributed to the formalization and standardization of the education of the surgical assistant by forming a committee that eventually forwarded recommendations for an advanced-level curriculum. Consequently, the first e

11 dition of the Core Curriculum for Surgic
dition of the Core Curriculum for Surgical (CCSA) was published in 1993, and the second edition was published the Association of Surgical Assistants (ASA) undertook the lead role in revising the CCSA to publish the third edition. In 2018-2019, ASA leadership, in partnership with the Accreditation Review Council on Education in Surgical Technology and Surgical Assisting (ARC/STSA) requested and incorporated inpu

12 t from all program directors of Commissi
t from all program directors of Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited programs and the ASA Education Committee for the review and revision of the fourth edition. A review of some of the primary assumptions that underlie the organization of the fourth edition are as follows: The foundational concepts for entry-level surgical assisting must be focused on surgical ana

13 tomy, physiology and The surgical assist
tomy, physiology and The surgical assistant must understand the relevant medical conditions of the patient that can affect the course of surgery and patient outcomes. The surgical assistant must have an in-depth knowledge of the surgical procedure and the patient’s medical chart and associated documentation including operative consent, history and physical, advance directives, results of diagnostic tests, radiog

14 raphic imaganesthetic principles includi
raphic imaganesthetic principles including local anesthetics and postoperative pain management positioning and surgical prep of the patient to provide optimum wound exposure while surgical anatomy, physiology, padure objective manipulation of tissue to minimize tissue injury thereby promoting wound healing methods for closure of the planes of the body safe utilization of instrumentation, equipment and supplies

15 necessary for the procedure emergency c
necessary for the procedure emergency conditions that may arrequires the individual to be able to “speak the language” of the surgeon and see the surgical procedure through the eyes of the surgeon in order to provide advanced surgical skills to co surgical patient care. As with any educational endeavor, the success of a core curriculum relies upon the ability to realize Core Curriculum for Surgical Assisting o

16 ne of the constants of education is that
ne of the constants of education is that it is ev curriculum relies on the fact it is a “living-breathing” document and requires updating in order to recognize the changes that occur in the dynamic professiTherefore, it is important to recognize that surgical assistant education sponsoring institution determines how the program content should be organized into indioptimal way to offer the courses according to t

17 he needs of its students and community.
he needs of its students and community. Surgical assisting education is flexible regarding the ability of institutions to adopt educational models that meet the needs of the community and the school, as well as the needs of the student. Currently, there are three models of education that meet the CAAHEP Standards and Guidelines Educational Programs in Surgical Assisting (all of which can be delivered through a

18 campus setting and/or methods of distanc
campus setting and/or methods of distance education): Surgical assistant program in which individuals accepted into the program have previously ompleted an entry-level surgical technology program. 1 + 1 model in which the individual completes an accredited surgical technology program and immediately moves into an accredited surgical assistant program. Surgical assistant program in which individuals accepted int

19 o the program have no previous introduct
o the program have no previous introductory surgical technology training. Students of this program expected to complete the scrub role, which includes case setup or scrub role perioperatively. The program awards a certificate/degree for surgical assistant only. Relevant introductory operating room components must be introduced as outlined in the most current AST Core Curriculum for Surgical Technology. See Sec

20 tion V. for a sample of the required co
tion V. for a sample of the required core introductory operating room Core Curriculum for Surgical Assisting I. SURGICAL SCIENCES Core Curriculum for Surgical Assisting SURGICAL ANATOMY, PHYSIOCOMMON COMORBIDITIES (DObjectives: The learner will Correlate surgical anatomy to suCompare and contrast normal anatomy to the pathophysiology as it reDescribe specific diseases and disorders (comorbidities) that can af

21 fect patient outcomes, lead to surgical
fect patient outcomes, lead to surgical emerDemonstrate an understanding of evaluating diagnostic images as related to surgical anatomy. Surface anatomy of thoracic wall Skeleton Joints Thoracic cavity Mediastinum Pleurae lungs Vessels Pulmonary circulation Pericardium When studying anatomy, the emphasis must be based on regional anatomy with surgical anatomy as the critical component, as opposed to the system

22 ic anatomy. Surgical anatomy is the crit
ic anatomy. Surgical anatomy is the critical factor with an emphasis on advanced anatomical knowledge that is applied towards the surgical Note: Be sure to include content identified in the current Curriculum for Surgical introduction. Core Curriculum for Surgical Assisting Great vessels Conduction system of the heart Mammary Abdominal cavityStomach Small intestine Vasculature Pancreas Surface anatomy Vascula

23 ture Core Curriculum for Surgical Assi
ture Core Curriculum for Surgical Assisting Surface anatomy Gallbladder Surface anatomy Spleen Surface anatomy Surface anatomy Lymphatic Ureters Surface anatomy Female Surface anatomy Adrenal glands (suprarenal glands) Surface anatomy Anterolateral abdominal wall Surface anatomy Internal surface anatomy Core Curriculum for Surgical Assisting Lymphatic Posterior abdominal wall Surface anatomy Abdominal aorta S

24 urface anatomy Arterial branches Portal
urface anatomy Arterial branches Portal system Surface anatomy Diagnostic images Walls and floors Joints Seminal vesicles Ejaculatory ducts Female reproductive organs and external genitalia External genitalia Core Curriculum for Surgical Assisting Uterine ligaments Vasculature Pelvic fascia General anatomy Superficial Female perineum Vasculature Relevant pathophysiology Diagnostic images Facial anatomy Core

25 Curriculum for Surgical Assisting Scalp
Curriculum for Surgical Assisting Scalp Cranial nerves Olfactory (I) Trigeminal (V) Facial (VII) Vestibulocochlear (VIII) Vasculature Orbits Eyelids Lacrimal apparatus Orbital contents Vasculature Oral cavity Vasculature Core Curriculum for Surgical Assisting Internal Superficial cervical Anatomical triangles Anterior cervical Curvatures Vasculature Spinal cord Vasculature Muscles of the back Deep neck m

26 uscles Extrinsic (superficial) Intrinsic
uscles Extrinsic (superficial) Intrinsic (deep) Upper appendicular Axilla Core Curriculum for Surgical Assisting Joints Acromioclavicular Vasculature Compartments Vasculature Joints Wrist Intercarpal Vasculature Joints Interphalangeal Lower appendicular Vasculature Lower limb Core Curriculum for Surgical Assisting Joints Posterior thigh Compartments Achilles tendon Vasculature Popliteal fossa Vasculat

27 ure Vasculature Arches Joints Core Cu
ure Vasculature Arches Joints Core Curriculum for Surgical Assisting TECHNOLOGICAL SCIENCES Objectives: The learner will Analyze the usage and safety features of each to ensure safe operation and optimal patient Describe the role of the surgical assistant withtissue. Electricity Principles ESU systems and safe operation Role of the surgical assistant Minimally invasive surgical equipmentPrinciples of tissue

28 manipulation Role of the surgical assis
manipulation Role of the surgical assistant Placement of secondary trocar Assisting the surgeon Principles Role of the surgical assistant in tissue manipulation Other technologies Core Curriculum for Surgical Assisting PHYSIOLOGICAL CHEMISTRY: ELECTROLYTES, FLUID AND SHOCK Objectives: The learner will 1. Summarize the physiological combetween plasma and interstitial lymphatic volumes. hypovolemic, septic,

29 hemorrhagicTotal body water composition
hemorrhagicTotal body water composition Compartments Solute composition Potassium Magnesium Intracellular levels Measurement of intracellular fluids with potassium Osmolarity Extracellular levels Distribution between plasma and interstitial lymphatic volumes oss the capillary Metabolic or respiratory Clinical interpretation Septic Hemorrhagic Fluid and electrolyte replacement Salts Core Curriculum for Surgi

30 cal Assisting Tonicities Colloid Soluti
cal Assisting Tonicities Colloid Solutions Core Curriculum for Surgical Assisting PHARMACOLOGY AND ANESTHESIA Objectives: The learner will 1. Analyze perioperative principles of patient assessment and how they relate to anesthesia. 2. Consider the goals of anesthesia as it relates to the perioperative patient in the surgical 3. Assess the risks and adverse effects of anesagents, and pain management4. Demonst

31 rate an understanding of anesthesia, con
rate an understanding of anesthesia, conscious sedation, locaand pain management as it relates to the perioperative patient. 5. Understand the principles of local injection techniques and topical anesthetic agents. Parenteral injection General anesthesiaVentilation assistance/airway management Temperature Electrocardiography Regional anesthesia Post-procedural pain management Local anesthetic drugs Classifica

32 tion Amino amide Core Curriculum for Su
tion Amino amide Core Curriculum for Surgical Assisting Allergic reactions Local Local anesthetic systemic toxicity Symptoms Peripheral effects CNS toxicity (seizures, coma) ardia/arrhythmia) Oxygen/benzodiazepine Intralipid emulsion Common local anesthetics Additives Epinephrine Kern’s rule Additives Potential liver toxicity (with infusions) Core Curriculum for Surgical Assisting E PERIOPERATIVE SET

33 TING Objectives: The learner will 1. A
TING Objectives: The learner will 1. Analyze the causes of surgical site infections (SSI). 2. Assess the clinical signs of specific SSIs. 3. Evaluate the methods for the prevention of SSIs. 4. Summarize the specific uses of antibiotics. Superficial Cavity Host susceptibility Tobacco products Existing infection Break in skin/mucous membrane Prevention techniques Maintain normothermia Antibiotic resistanc

34 e Intrinsic (carrier) Patient antibiotic
e Intrinsic (carrier) Patient antibiotic resistance Sterile technique Antimicrobial prevention of SSIs Core Curriculum for Surgical Assisting Antimicrobial agents Penicillins Tetracyclines Combination agents Coly-Mycin S Otic Metronidazole Polymixin B sulfate 4: Dirty/infected species Clostridium species Enterococcus species Escherichia coli Klebsiella species species species Methicillin-resistant (MRSA) C

35 oagulase-negative Staphylococcus Multidr
oagulase-negative Staphylococcus Multidrug resistant species Cytomegalovirus (CMV) Hepatitis Specific surgical site infections (SSI) Core Curriculum for Surgical Assisting Soft tissue infections Subcutaneous abscess Cellulitis Intra-abdominal infections Intra-abdominal abscess Retroperitoneal abscess Prosthetic infections Cardiac valves Pacemakers Total joint prostheses n-surgical infections Clostridium spe

36 cies Enterococcus species Mycobacterium
cies Enterococcus species Mycobacterium tuberculosisPseudomonas species species species Core Curriculum for Surgical Assisting HEMATOLOGICAL PRINCIPLES OF SURGERYObjectives: The learner will hemostasis and coagulation. mostasis and coagulation. 3. Demonstrate an understanding of disseminated intravascular coagulation. and uses of blood components. 6. Demonstrates ability to choose the appropriate method

37 of hemostasis and apply as Hemostasis C
of hemostasis and apply as Hemostasis Chemical Hepatic failure Renal failure Disseminated intravascular coagulation Blood replacement interventions Patient education Diseases processes Effects of certain medications Surgical intervention Infection Core Curriculum for Surgical Assisting Hemostatic agents Antibiotics Presence of cancer Collection Intraoperative Collection Collection Screening Allergic Hemolytic

38 transfusion reaction Infection Red cells
transfusion reaction Infection Red cells Core Curriculum for Surgical Assisting Objectives: The learner will in wound closure, healing and complications. 3. Demonstrate the techniques involved 4. Demonstrate knowledge of wound drAnatomy of the skin Epithelial cells Layers (outer to inner) Stratum corneum Stratum lucidum Stratum spinosum Stratum basale Dermis (corium) Elastic connective tissue Layers (outer

39 to inner) Stratum papillare Stratum re
to inner) Stratum papillare Stratum reticulare Accessory structures Nails Ciliary Mammary Camper’s Fascia Core Curriculum for Surgical Assisting Tissue injury and response Traumatic Simple Complicated Clean Contaminated Inflammatory process Acute inflammation Characteristics Resolution Chronic inflammation Characteristics Resolution Characteristics Resolution Vasoconstriction Platelet activation/aggregati

40 on Wound healing First intention Phases
on Wound healing First intention Phases Third intention (delayedScars Normal scar – cicatrix Core Curriculum for Surgical Assisting Metabolic Hematologic Hemorrhagic Malignancy Immunocompromised Nutritional status Infection Hemostasis Complications Evisceration Hemorrhage Infection Suture ligature/stick tie Left-handed Core Curriculum for Surgical Assisting Instrument tie Determination of method Purse string

41 Retention Traction Stick tie/ligature R
Retention Traction Stick tie/ligature Rigid/Immobilization Core Curriculum for Surgical Assisting Objectives: The learner will cal agencies that are involved in disaster planning and can occur as a caregiveDescribe the role(s) of the surgical assistant during a disaster. Hazards Chemical Radiation Personal disaster plan A. Family 3. Designated meeting places Federal, state and local agencies Federal Emergenc

42 y Management Agency (FEMA) cal System (
y Management Agency (FEMA) cal System (NDMS) Emergency Operations Plan (EOP) Mitigation Preparedness Mass casualty – patient care Healthcare facility Teaching All-HazardsThis is meant to be a review of focus on the various roles the surgical assistant can perform disaster situations. For a comprehensive outline of all-hazards preparation refer to the Core Curriculum for Surgical Core Curriculum for Surgical

43 Assisting II. THE SURGICAL ASSISTANT Co
Assisting II. THE SURGICAL ASSISTANT Core Curriculum for Surgical Assisting OBJECTIVES Objectives: The learner will e surgical assistant. ce for the surgical assistant. nizations that impact the surgieach. to build effective teams. or ethnical differences that coct resolution skills and the 9. Identify methods of stress management. e surgical assistant. 13. Analyze the significance of HCAHPS (Hospital Con

44 sumer Assessment of Healthcare nt/physi
sumer Assessment of Healthcare nt/physician satisfaction to the success of the team and healthcare organization Core Curriculum for Surgical Assisting SURGICAL ASSISTANT ROLE cal assisting American College of Surge Core Curriculum for Surgical Assisting Interpersonal Skills Communication Teamwork Relationship Cultural and religious differences Conflict management Emotional intelligence Self-reflection Organi

45 zational skills Credentialing Core Curr
zational skills Credentialing Core Curriculum for Surgical Assisting LEGAL AND ETHICAL RESPONSIBILITIESPatient safety – OR hazards – common incidents Patient misidentification Incorrect positioning of the patient Defective equipment and supplies Major break in aseptic technique Exceeding authority Breach of confidentiality Legal terms Liability insurance Informed consent Intentional breach Dereliction/failur

46 e to meet standard Foreseeability of har
e to meet standard Foreseeability of harm existed Patient rights Caregiver’s rights Sentinel event Core Curriculum for Surgical Assisting Quality control Patient safety n (Example: SCIP, Team STEPPS, etc.) Commitment to “do the right thing” Surgical conscience Core Curriculum for Surgical Assisting BUSINESS PRACTICES Business ethics Liability Introduction to billing practices Inform patient Claim submissi

47 on Accurate documentation Timely documen
on Accurate documentation Timely documentation Use of software/billing companies Claim denials Importance of cash-flow – the reality Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting PREOPERATIVE SURGICAL MANAGEMENT Objectives: The learner will 1.Review preoperative information. Demonstrate an understanding of the role of assessment phase. Assess potential perioperative complic

48 ations. Interpret surgical listing info
ations. Interpret surgical listing information into predicted tasks of the surgical assistant role in Summarize the indications, considerations and complications of urinary catheterization. rious surgical specialtirgical positioning on the patient. Describe the application of vaIdentify circumstances and complications associated withDiscuss the types of surgical skin preparations. Explain the rationales for de

49 termining the e for each surgical specia
termining the e for each surgical specialty. Core Curriculum for Surgical Assisting TIENT ASSESSMENT Preoperative assessment of the patient Allergies and types of reactions er-the-counter medications Current symptoms Previous surgery and anesthesia experiences (MH, anaphylaxis, difficult intubation) Medical conditions(s) and comorbidities Congenital conditions Cognitive ability Vital statistics Imaging

50 Review and complete institutional preope
Review and complete institutional preoperative checklist Preoperative fasting Site marking anesthesia-related complications Core Curriculum for Surgical Assisting PREOPERATIVE SKILLS Urinary catheterization Resolve complications No urine return Catheter defects Positioning the surgical patient Surgical access Anesthesia access Invasive line access General considerations Team communications Protect catheters

51 and IV lines Evaluate surgical posimeta
and IV lines Evaluate surgical posimetal parts on OR table Effects of positioning on body systems Morbidly obese Role of surgical assistant in patient positioning Patient assessment to determine OR table Jackson Core Curriculum for Surgical Assisting Patient assessment to determine stabilization devices Surgeon’s preferences Lithotomy Fowler’s Patient evaluation Role of surgical assistant Pressure setting C

52 omplications Patient skin preparation Co
omplications Patient skin preparation Communication with team Surgeon’s preference Core Curriculum for Surgical Assisting Patient factors Allergies Timing Paint only Role of surgical assistant Postoperative skin assessment Factors that affect choice of drapes Patient Head/neck Laparotomy Upper extremity Lower extremity Role of the surgical assistant Communication with team Surgeon’s preferences Core Curri

53 culum for Surgical Assisting Section B1.
culum for Surgical Assisting Section B1. Intraoperative Management Core Curriculum for Surgical Assisting INTRAOPERATIVE SKILLS Objectives: The learner will: Apply knowledge of patient skin assessment as it relates to the various surgical Apply knowledge in the selection and use of surgical instruments, and demonstrate Identify potential patient safety issues of instrument usage. Demonstrate selection and use

54 of specialized equipment. Determine and
of specialized equipment. Determine and demonstrate method(s) for achieving optimal operative site exposure according to the surgical procedure. Diagnostic interventions Preoperative patient preparation Positioning the patient Draping the patient Communication with team Surgeon’s preference Verify equipment availability Communicate solution(s) to surgeon Application of intraoperative skills Trocar placement Util

55 ization of suction Maximum absorption Pr
ization of suction Maximum absorption Protection Absorption Packing Dissection Retraction Digital retraction Core Curriculum for Surgical Assisting Instrument retraction Factors affecting choice of retractor(s) Structures to be retracted Tissue dissection Special equipment Application Complications Application Complications Irrigation Headlights Usage of surgical instrumentation Communication with team Surgeon

56 ’s preferences Confirm needed instrument
’s preferences Confirm needed instrumentation Handling Application Match instrument to Errors in usage Inadequate visualization Core Curriculum for Surgical Assisting Section B2. Surgical Procedures Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – DIDACTICObjectives: The learner will: 1. Correlate the relevant advanced surgical anatomy to the surgical procedure. 3. Analyze the specific patient care

57 factors the surgical assistant should c
factors the surgical assistant should coordinate with the surgical team. being performed. surgical procedures. 7. Discuss the postoperative care of the surgical wound. Co-Related Procedures ConceptThere are surgical procedures that are similar surgical assistant. This is referred to example, colon resection is , small bowel resection is not listed since it is the same co-related procedure. The instructor

58 has the academic freedom to either info
has the academic freedom to either inform the student that small bowel resection is performed like the colon resection or go above and beyond CCSA requirements and teach small bowel resection. The purpose of the Co-Related Procthe classroom. Diagnostic interventions Preoperative patient preparation Positioning the patient Draping the patient Role of surgical assistanRole of surgical assistant Core Curriculum f

59 or Surgical Assisting Breast biopsy with
or Surgical Assisting Breast biopsy with needle localizdioactive seeds Lumpectomy Simple mastectomy Modified radical mastectomy Axillary node dissection Gastrostomy Bariatric surgery Sleeve gastrectomy With colostomy Pancreaticoduodenectomy (Whipple procedure) Anal fissure Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – OBSTETRIC AND GYNECOLOGICC-section Total abdominal with/out BSO Supracervica

60 l hysterectomy Wertheim procedure (radic
l hysterectomy Wertheim procedure (radical hysterectomy) Total pelvic exenteration Vulvectomy Pelvic i-Kranz [MMK] or Vesicourethral suspension Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – GENITOURINARYWilms’ tumor excision Ureteroscopy Ureterostomy Suspension (TVT/sling) Prostate Penile Penile implant Vasovasostomy Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – OPHTHALMICEnucle

61 ation Strabismus recession and resection
ation Strabismus recession and resection Core Curriculum for Surgical Assisting SURGICAL PROCEDURES Mastoidectomy Caldwell-Luc Parotidectomy Glossectomy Core Curriculum for Surgical Assisting Upper extremity Repair of rotator cuff Total shoulder arthroplasty ORIF Fasciotomy External fixation Colle’s fracture Smith fracture Fasciotomy Lower Extremity Pelvic ORIF Spica casting External fixator ORIF ORIF Fascio

62 tomy Knee arthroplasty (total, hemi-, un
tomy Knee arthroplasty (total, hemi-, uni-) ORIF Core Curriculum for Surgical Assisting Triple arthrodesis Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – PLASTIC AND RECONSTRUCTIVE Congenital reconstruction Cheiloplasty/palatoplasty Mammoplasty Breast reduction Abdomen Split thickness graft Full thickness graft Pedicle grafts Reattachments of hand/foot/digit Maxillary fractures Zygomatic (orbital

63 blowout) fractures Gender reassignment
blowout) fractures Gender reassignment Core Curriculum for Surgical Assisting SURGICAL PROCEDURLaminectomy Discectomy Tumor removal AV malformation Stereotactic procedure Nerve transposition Carpal tunnel release Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – CARDIOTHORACICPectus excavatum/carinatum Video-assisted thoracic surgery (VATS) Adult cardiac procedures Aortic aneurysm repair Valve

64 repair Pacemaker insertion Pediatric car
repair Pacemaker insertion Pediatric cardiac procedures Repair of coarctation of the aorta Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – PERIPHERAL VASCULARAbdominal aortic aneurysm repair Percutaneous transluminEndograft placement (Greenfield filter) Endarterectomy Carotid stenting Carotid TCAR Core Curriculum for Surgical Assisting SURGICAL PROCEDURES – PROCUREMENT Saphenous vein graft Ste

65 rnal bone marrow Core Curriculum for Su
rnal bone marrow Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting POSTOPERATIVE MANAGEMENT Objectives: The learner will Identify the key components of the transfer of care. s and treatment. Transfer of care Non-steroidal anti-inflammatoAlternate therapies Dressings and immobilization devices Common complications, emergencies Hemorrhage Infection Anesthesia related Paralytic ile

66 us Positioning or pressure related Core
us Positioning or pressure related Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting SURGICAL ASSISTANT CLINICAL REQUIREMENTSThe student must complete 140 documented surgical procedures in the role of the surgical assistant. A minimum of 20 cases must be performed in general surgery with the remaining cases ter the program with no previassistant and are approved by the program. Oral

67 /maxillofacial Pediatrics Core Curricul
/maxillofacial Pediatrics Core Curriculum for Surgical Assisting SURGICAL ASSISTANT CASE COUNTS Reviews surgical record including patient information history, preoperative tests (EKG, EEG, EMG, lab values, diagnostic imaging), safety measures, biopsy results. Communicate surgeon’s preferences to surgical team, i.e., suture needs, specialty supplies, positioning of patient, etc. according to surgeon’s preference

68 . nt; communicate surgeon’s preference t
. nt; communicate surgeon’s preference to the surgical team. Injects local anesthesia, aapplication of hemostatic agents, ESU hemostasis, as appropriate to the operative site. POSTOPERATVE Transfers patient. rgical experience, the following applies: All surgical case experiences, including observation and second assisting, in addition to the required 140 first assistant cases must be included in case log docum

69 entation. Core Curriculum for Surgical
entation. Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting REQUIRED INTRODUCTORY OPERATINGREGARDING SURGICAL TECHNOLOGY* Sample of required introductory operating room core components for programs that accept room experience or education. See the most recent edition of the AST Core Curriculum for Surgical TechnologyPharmacology and anesthesia Microbiology Technological science

70 concepts Electricity Patient care concep
concepts Electricity Patient care concepts Nonsterile Attire Patient identification Surgical consent Positioning Urinary catheterization Skin preparation Instrumentation Asepsis and sterile technique Surgical counts Intraoperative: Sterile Specimen care Hemostasis Core Curriculum for Surgical Assisting Tissue replacement materials Postanesthesia care unit Environmental disinfection of the OR Assistant circulato

71 r role Surgical specialties Obstetric an
r role Surgical specialties Obstetric and gynecology Oral and maxillofacial Plastic and reconstructive Cardiothoracic Surgical rotation Ethical and moral issues Healthcare facility information Healthcare facility orgaPhysical environment All-hazards preparation Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting JOB DESCRIPTION: SURGICAL ASSIST

72 ANT College of Surgeons (ACS), Accredita
ANT College of Surgeons (ACS), Accreditation Assisting (SASA), and the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and include this description of optimal results for the patient. duties, the surgical assistant also performs rative duties to better facilitate proper patient care. The surgical the surgeon and in accordance with hospital policy and appropriate laws and regulations. acc

73 reditation agency of the Council for Hig
reditation agency of the Council for Higher Eaccredited by agencies recognized by the United States Department of Education (USDE), the Joint Commission, or a state agency acceptaARC/STSA is also a member of the Association of SpecializedCredentials Assisting (NBSTSA). Initial certification as a Certified Surgical First Assistant (CSFA) is NBSTSA. CSFAs maintain their certificatieducation in a two-year period or

74 by successfully retaking the certifying
by successfully retaking the certifying examination at the The NBSTSA’s certification program is accredAgencies (NCCA), the accreditation division of the Institute for Credentialing Excellence (ICE) and is in compliance with NCCA’s Core Curriculum for Surgical Assisting surgical assistants, supports the accreditation of all surgical assisting educational programs, r surgical assistants is the Association of Su

75 rgical es (AORN). ASA represents the int
rgical es (AORN). ASA represents the interests of ASAs primary purpose is to ensure that surgical assistants have the knowledge and skills to administer patient care of the highest quality. The ASA is the principal assistants. ASA also works with AST, ARC/STSA and NBSTSA to set standards for educatiorepresents the profession at state and national levels to ensure that all surgical assistants attain Positioning

76 the patient The surgeon shall convey the
the patient The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistanwill be given to the patient’s comfort and safety. Points of pressure shall be padded: elbows, heels, knees, eyes, face, and axillary Nerve damage shall be guarded against. The surgical assistant shall be familiar with common positions related to the surgical procedure and wi

77 ll be able to use the equipment necessar
ll be able to use the equipment necessary to provide the position. Competencies will include the following: Fracture tables Head stabilizers C-arm extensions Core Curriculum for Surgical Assisting be carried out. Providing visualization of the operative site by the following: retractors with or without padding Packing with sponges Suctioning, irrigating, or sponging (e.g., loops, tags, running sutures) t obstru

78 ction of the surgeon’s view to assist wi
ction of the surgeon’s view to assist with hemostasis Permanent zing vessels or tissue amped vessels or tissue Applying hemostatic clips Placing local hemostatic agents dge of side effects of Applying vessel loops Participating in volume replacement or autotransfusion techniques as appropriate ssist with closure of body planes Utilizing running or interrupted sutures with absorbable or nonabsorbable material of

79 wound layers, including muscle and fasci
wound layers, including muscle and fascia Utilizing subcuticular closure technique with or without adhesive skin closure strips s directive (suture, staples, etc.) jection of local anesthetic per surgeon’s directive und dressings, including the following: Liquid or spray occlusive materials Absorbent material affixed with tape or circumferential wrapping Immobilizing dressing (soft or rigid) ng drainage systems

80 to tissue Core Curriculum for Surgical
to tissue Core Curriculum for Surgical Assisting REQUIRED LAB SKILLS REQUIRED SURGICAL SKILLS PART 1 for the student who enters the program with no previous surgical experience. PPE, OR attire Vital sign assessment inclAssists with intubatiPositioning (includes positioning tools/table operation) Sterilization equipment Stapling devices Additional skills intraoperatively Irrigation Core Curriculum for Surgical

81 Assisting Lab skills required and demon
Assisting Lab skills required and demonstrated by all students enrolled in an accredited Stick tie/ligature Local injection target training (skills experience) Core Curriculum for Surgical Assisting assistance. Please feel free to contact them Eastern Virginia Medical School, Norfolk, VA, Contact: crewsrc@evms.edu Surgical Assisting Delta College University Center, MI, Contact: rebeccahall@delta.edu Mary

82 (Libby) McNaron, CST, CSFA, RN, MSN, FAS
(Libby) McNaron, CST, CSFA, RN, MSN, FAST, Chair Surgical Assisting Program Director, Gulf Coast State College, Panama City, FL, Contact: Lmcnaron@gulfcoast.edu Sarah Penkava, RN, MS, Surgical Assisting Program Director, Mayo Clinic College of Medicine and Science, Rochester, MN, Contact: penkava.sarah@mayo.edu Examples of entry requirements of programs No medical related experience B.Certified Surgical Techn

83 ologist with no working experience Bach
ologist with no working experience Bachelor’s degree with no experience Associate degree with me E.Bachelor’s degree with related medical experience F.Certified Surgical Technologist with two years' surgical experience Physician assistant Registered nurse Surgical Assistants; ACS – American College of Surgeons; and Surgical Assisting; CAAHEP – Commission on Accreditation of Allied Health Education Progr

84 ams; AST – Association of Surgical Tech
ams; AST – Association of Surgical Technologists; www.ast.org NBSTSA – National Board of Surgical Technology and Surgical Assisting; www.nbstsa.org AAMI – Association for the Advancement of Medical Instrumentation; NSAA – National Surgical Assistant Association; CAAHEP and ARC/STSA Standards and Standards for Surgical Assisting Standards Interpretive Guide for Surgical Assisting n of Surgical AssistPosition

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statements Guidelines Core Curriculum for Surgical Assisting Berríos-Torres SIGuideline for the Prevention of Surgical Site InfectionVol. 1 and Vol. 2, 11McGraw and Hill. CDC Procedure Associate Module SSI: FEMA Emergency Management Institute. Accessed July 10, 2019. gical Technologist: A Positive ed. Albany, NY: Cengage Learning. Frezza, E. (2007). The Business of Surgery.Kauffman K. (2017) Infectious Disea

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ses Acat https://www.infectiousdiseasead Kollef M, Micek S, Hampton N, Doherty JA, Kumar A. Septic Shock Attributed to Infection: Importance of EmpiClinical Infectious Diseases Clinically Oriented AnatomyOperative Anatomy,and Wilkins. Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting Core Curriculum for Surgical Assisting www.ar