Surgical First Assistant Vs. Certified First Assistant

The Surgical First Assistant and the Certified First Assistant in surgery titles can cause confusion for those interested in surgical assisting careers. Both health professionals serve as members of a surgical team, but differ in experience and training levels. Because a number of organizations issue credentials and guidelines in the field, there are ongoing efforts to clarify roles and standardize qualifications for these important roles.

Background

• Both the Surgical First Assistant (SFA) and the Certified First Assistant (CFA) provide assistance to surgical teams in operating rooms. Training programs for both are offered at colleges, community colleges, hospitals, the military, vocational schools and online. Because of possible title changes and job descriptions for these roles, it is best to do careful research to ensure that you apply for the program that best fits your needs. With additional experience and education, a Certified First Assistant can progress to the position of Surgical First Assistant, according to the Bureau of Labor Statistics.

Surgical First Assistant Education

• An SFA training program usually requires prior operating room experience, and CFA or Certified Surgical Technologist (CST) designation. Entrance requirements vary, sometimes requiring a bachelor's degree; some accept credentials such as an RN, Certified Nurse Operating Room (CNOR) or Certified Physician's Assistant designation. Typically, students take courses in human anatomy and physiology, medical terminology, surgical pharmacology, anesthesia, general and specialty surgical procedures, wound care and microbiology supplemented by supervised clinical experience. Programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) take from 10 to 22 months.

The SFA in the Operating Room

• The SFA helps the surgeon before, during and after a surgical procedure. Some responsibilities, conducted under supervision, include draping the patient, hemostasis (control of bleeding) through pressure or use of instruments or chemical agents, maintaining sterile conditions, providing retraction, clamping and tying cut tissue, closing wound layers and inserting drainage tubes. Responsibilities vary according to the type of surgery and will sometimes include selecting and applying dressings, assisting with resuscitation if needed, and harvesting veins or incision tissue. Responsibilities increase with experience and competence.

Certified First Assistant Education

• Accredited CFA training programs require a high school diploma with coursework in biology, mathematics and chemistry recommended. Some programs require certification as a CST. CFA training includes anatomy, physiology, medical terminology, pharmacology, sterile techniques and surgical procedures plus supervised clinical experience. CPR certification is recommended, as is experience in an operating room environment. Training programs last from three to six semesters, followed by a certification examination.

The CFA in the Operating Room

• Under the direction of the surgeon, CFAs assemble instruments and equipment, sterile drapes and surgical solutions. A CFA helps the surgical team put on sterile gowns and masks, drape patients, and during surgery may pass required instruments. They assist with control of bleeding, hold retractors and help apply dressings. Some monitor patient vital signs and transport patients to and from the operating room, while some operate sterilizers, suction machines or diagnostic equipment. Prior experience and education level determine the extent to which the CFA participates. Both SFAs and CFAs receive certification from the National Board for Surgical Technology and Surgical Assisting.