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June 29, 2025, 3:35 p.m.
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2023-10-16
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SOURCE: Quick J. Surgical First Assistant. The Essentials of Practice 2025
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Textbook in PDF format A critical examination of an increasingly vital role in surgical practice Surgical first assistants (SFAs) are registered nurses or operating department practitioners (ODPs) who play a crucial role in the operating theatre during surgical procedures. Under the direct supervision of the operating surgeon, an SFA provides continuous skilled assistance, performing a range of established responsibilities to assist the surgeon predominantly in the intraoperative phase of the patient's journey, but also in the pre- and post-operative phases. The role affords theatre nurses and ODPs the opportunity to expand their clinical responsibilities and provide assistance for patients undergoing surgery by undertaking post-qualifying education. More recently, an understanding of the knowledge and skills of the SFA role has been embedded into the undergraduate curricula for ODPs. Surgical First Assistant: The Essentials of Practice provides a comprehensive and critical examination of the knowledge, skills and behaviours that are required by SFAs to ensure patient safety and quality care. Beginning with a historical overview of the SFA role, it proceeds to outline the legal, ethical and professional aspects of the role which allows the practitioner to critically reflect on SFA practice. It also offers an in-depth analysis of the SFA's responsibilities as defined by the Perioperative Care Collaborative through each phase of the patient's perioperative journey from pre-operative assessment to post-operative pain management. Surgical First Assistant readers will also find A text aligned with UK national standards and best practice Detailed discussion of topics including pre-operative preparation with the operating theatre, assisting with haemostasis, and many more An approach which explores both the technical and non-technical skills required by the SFA Surgical First Assistant is ideal for registered nurses, ODPs, student and apprentice operating department practitioners Essential Concepts Of surgical First Assistant Practice The Historical Context Of the Surgical First Assistant The Role Of the Non-medical Surgical Assistant During Conflict Lewin’s Report Certification National Accreditation National Association Of assistants In surgical Practice Call For clarity over Names A National Sfa Toolkit The Responsibilities Of the Sfa References Ethical, Legal and Professional Considerations of the Sfa Role Autonomy Beneficence Nonmaleficence Justice Case Studies Scenario 1 Signpost Scenario 2 Signpost Scenario 3 Signpost Scenario 4 Signpost References The Perioperative Role of the SFA Preoperative Assessment Preoperative Assessment Patient Education Venous Thromboembolism Risk Assessment Tissue Viability Patient Mobility Ward Preparation – Patient Fasting Fasting Instructions For adult Elective Surgery Patient Fasting Instructions For adult Emergency Surgery Patient Fasting Instruction for Children Surgical Site Marking Decision-making And informed Consent References Pre-operative Preparation Of the Patient Within the Operating Theatre Introduction Team Brief Timeout Patient Positioning Skin Preparation Chlorhexidine Gluconate Povidone-iodine Draping The patient Conclusion References Assisting with Surgical Incisions and Wound Closure Surgical Incisions Before Knife-to-skin Site And length Of incision Choice Of instruments For surgical Incision Minimally Invasive Surgery Skin Marking Common Types Of surgical Incisions Assisting With the Surgical Incision Wound Closure Types Of surgical Wounds Wound Healing Wound Closure Techniques For skin Closure Suturing Other Closing Devices Assisting With wound Closure Closing A surgical Wound Wound Drainage References Assisting With haemostasis During Surgery Introduction Pressure Suction And visual Access Sutures Clips And ties (arterial Clamps) Single Use Clips Surgical Stapling Devices Diathermy Ultrasonic Devices Laparoscopic And haemostasis Pharmacological Methods And haemostatic Agents Conclusion References Tissue Handling and Retraction Introduction Tissue Viability Assessment Tissue Types Skin Adipose Tissue Muscle Organs Vasculature And nerves Bone The Responsibilities Of the Sfa Handling Of tissue Types Of retractor Retraction by Hand Hand-held Retractors Self-retaining Retractors Implications Of tissue Handling And retraction References Instrument Handling For the Surgical First Assistant Introduction The Use Of handheld Retractors Retracting Away From oneself Retracting Towards Oneself Tissue Forceps Skin Hooks Handling Artery Forceps Suture Scissors Minimal Access Surgery Other Instruments Requiring Consideration The Practitioner With extended Skills Toothed Dissecting Forceps Needle Holders References Wound Management Introduction Acute And chronic Wounds Wound Healing Phase 1 Phase 2 Phase 3 Phase 4 Haemostasis Inflammation Proliferation Remodelling/maturation Local Factors Systemic Factors Biopsychosocial Factors Wound Care Patient Education Wound Assessment Anatomic Location And type Of wound Degree Of tissue Damage Wound Bed And edges Wound Size And peri-wound Signs Of infection Pain Dressings Self-adhesive Absorbent Dressings Soft Paraffin Gauze Alginates Negative Pressure Wound Therapy Conclusion References Pain Management Introduction Defining Pain Classifying Pain Assessing Pain Tools Pain Assessment Questions Using Pqrst Example Of a Functional Activity Scale Managing Pain Approaches To analgesia Unrelieved Pain Role Of the Inpatient Pain Management Service Patient Education Analgesic Medicines Multimodal Analgesia Paracetamol Opioids Gabapentinoids Alpha-2 Agonists: Clonidine And dexmedetomidine Ketamine Local Anaesthetics Nerve Blocks Neuraxial Analgesia Fascial Plane Blocks Conclusion References Human Factors and Non-technical Skills Human Factors Introduction Implications Of human Factors Patient Safety In surgery Human Error Patient Safety Incident Response Framework Sfa’s Well-being Conclusion References Non-technical Skills Introduction Classification Of non-technical Skills Situation Awareness Communication And teamwork Task Management Leadership And decision-making Managing Stress And fatigue References Index
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