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Surgical First Assistant Job Description

Put broadly, if a surgical tech is responsible for the tools a surgeon uses during a procedure and the surgical first assistant (or just surgical assistant) helps out with the actual surgery itself. While both life-saving positions are important to any operating theater, the surgical tech job description typically focuses more on the sterility of the procedure and other more clinical aspects.

In this high precision role, the assistant (or SA) works closely with the surgeon in a hands-on capacity, helping the surgeon by handling vital tasks such as prepping the patient for surgery, providing suturing, clamping, removing scar tissue and positioning patients during surgery to ensure a safe operation. Because the surgical first assistant job requires such honed skills and specific training, the salary range is generally above the pay grade for surgical techs, surgical second assistants, entry level assistants or physicians assistants.

Duties of a Surgical First Assistant

A Surgical First Assistant is usually the  surgical assistant with the highest level of expertise and training. While first assistants are expected to perform different tasks at different medical locations, they are generally trained and certified to perform and be proficient in the following tasks among others:

  • Cauterizing wounds and vessels
  • Packing sponges in body
  • Positioning patient to maintain circulation and access for surgeon
  • Placing clamps and sutures
  • Closing skin with adhesives, sutures or staples etc.
  • Applying direct pressure on veins and tissue
  • Performing or aiding in patient suction, drainage and irrigation
  • Hemostasis: The stopping of excess bleeding and blood flow
  • Immobilizing patients on the operating table

Surgical First Assistant Fields of Specialization

Surgical First Assistants can add to their usefulness and odds of employment by learning the skills to be a specializing surgical first assistant in some of the following specialties:

  • General surgery
  • Neurosurgery
  • Obstetric surgery
  • Cardiac surgery
  • Thoracic surgery (chest)
  • Vascular surgery
  • Trauma surgery/ trauma units
  • Ophthalmic surgery
  • Urinary / Genital surgery
  • Craniofacial surgery
  • Oral surgery
  • Ear, nose and throat surgery
  • Reconstructive surgery
  • Juvenile surgery (and related issues)
  • Geriatric surgery
  • Laparoscopic surgery
  • Automated / robotic surgery
  • Hand surgery
  • Orthopedic surgery
  • Plastic surgery

In addition, an experienced surgical first assistant will have opportunities to work in the areas of education as a teacher or to use their expertise in the fields of hospital and clinic management.

Becoming a Surgical First Assistant

There are typically three main ways to become a surgical first assistant. Though each route has its pro’s and con’s, some require more training time and education than others.

Certified Surgical Assistant – Surgical techs who decide they want a more hand’s on role in operating room often times opt for this route. Graduates from a CCAEHP accredited programs go on to earn their CSA/CFA by passing the CSFA exam offered by the NBSTSA (The National Board of Surgical Technology and Surgical Assisting). While these 1-2 year programs are often the fastest way to become a surgical assistant, not every state employs CSAs and several insurance companies don’t recognize them.

Certified Registered Nurse First Assistant – Another type of surgical assisting for RN’s with their Bachelor’s in nursing. Nurses with 1-2 years experience in an operating room environment and their CNOR can take the exam to became a CRNFA. While this six year process opens up many more job opportunities, CRFNAs in states that recognize CSAs are in competition for the same job. The benefit of becoming a CRFNA being that they can always transition into a different field of nursing.

Surgical Physician Assistant – This is one of the more difficult types of surgical assisting to get into. Physicians assistant schools are attended in conjunction with a typical Bachelor’s program and often only accept those at the top of their class. This path can take anywhere from 5-6 years to complete and gives graduates a range of employment opportunities in and outside of the surgical profession as talented PAs are in high-demand in every sector of the medical field.

Traits of a Successful Surgical First Assistant

Given the competitive nature of the field, it’s important that a surgical first assistant maintain the proper reputation and credentialing in their field. Factors which affect a Surgical First Assistant’s reputation and employability include:

  • Hours serving as a SA during surgeries
  • Sponsorship by one or more surgeons
  • A degree in a related field such as nursing or health
  • Real life experience such as work as an MD, nurse, EMT or military medic

Successful surgical assistants also pursue certification as a way of validating their skills and continuing education in the eyes of potential employers. The National Board of Surgical Technology and Surgical Assisting (NBSTSA) oversees the credentialing of both surgical techs and assistants with their Certified Surgical First Assistant (CSFA) exam. In addition, the National Surgical Assistant Association (NSAA) offers the Certified Surgical Assistant (CSA) credential, and the American Board of Surgical Assistants (ABSA) offers the Surgical Assistant-Certified (SA-C) credential.

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