Loading

Certified Surgical First Assistant

This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Fusion Medical Staffing.

  • 0 = Not Applicable
  • 1 = No Experience
  • 2 = Some Experience
  • 3 = Intermittent Experience
  • 4 = Experienced
  • 5 = Very Experienced
*Required
n/a
1
2
3
4
5

* Required

Miscellaneous

Adult Respiratory/ Cardiac Arrest*

Autoclave*

Automated Med Dispensing Systems*

Care of Scopes & Fiberoptic Equipment*

Cidex Soap*

Crash Cart*

Defibrillator*

Electronic Documentation*

Hand-off Communication*

Isolation Precautions*

Patient Identification*

Pediatric Respiratory/ Cardiac Arrest*

Standard Precautions*

Universal Protocol*

Follow Legal and Ethical Standards*

Recognize and Report Safety/Environmental Hazards*

Pre-Operative Preparation

Check Integrity of Packaging Sterile Supplies*

Confirm Advanced Directives in Chart*

Adhere to Radiologic/Surgical Techniques and Safety*

Utilization of Infection Control Protocols*

Open Sterile Supplies Utilizing Aseptic Techniques*

Participate in Time Out*

Assist with Patient Transfer*

Perform Inspection of Equipment Used in Procedure*

Troubleshoot or Remove Malfunctioning Equipment from Service*

Assemble and Perform Testing on Positioning Equipment*

Remove Pre-Op Devices*

Perform Sterile Scrub Don and Doff*

Assist Team Members in Sterile Don and Doff*

Prepare Operating Room Environment*

Confirm Operative Consent*

Obtain and Review Lab/Diagnostic Tests*

Confirm and Review Patient's H&P Chart*

Position Patient Per Surgeon's Order*

Drape Patient*

Confirm Availability of Surgical Instruments/Equipment/Supplies According to Procedures and Surgeon*

Review/Revise Surgeon's Preference Card, As Needed*

Perioperative Care

Position Patient Per Surgeon's Order*

Pressure Point Paddling*

Apply Tourniquet as Ordered*

Protect From Nerve Damage*

Thermoregulation*

Use of Fracture Table*

Use of Head Stabilizer*

Use of Body Stabilizer*

Use of C-Arm Extensions*

Skin Assessment*

Use of Retractors*

Packing with Sponges*

Digital Manipulation of Tissue*

Suctioning, Irrigation, Sponging*

Manipulation of Surgical Materials (Loops, Tags)*

Clamping/Cauterizing Vessels or Tissues*

Tying/Ligating Clamped Vessels or Tissues*

Apply Hemostatic Clips*

Place Local Hemostatic Agents*

Direct Digital Pressure*

Assist in Volume Replacement*

Assist in Autotransfusion*

Suturing: All Wound Layers, Including Muscle and Fascia*

Wound Dressing: Liquid or Spray Occlusive*

Absorbent Immobilizing Dressing*

Assist to Secure Drainage System to Tissue*

Insert/Remove Foley*

Drape Patient*

Electrocautery Mono*

Electrocautery Bipolar*

Cut Tissue*

Harvest Saphenous Vein, Including Skin Incision*

Dissect Common Femoral Artery and Bifurcate*

Insert Drainage Tubes*

Perform Removal of Sutures/Staples*

Add Stapling with Sutures*

Perform Patient Assessment and Document Appropriately*

Monitor Patient's Status During Surgical Procedure*

Application of Post-Op Devices*

Perform Sterile Verification of Medication and Solutions*

Administer Medications, As Needed*

Monitor for Adverse Pharmacologic Reactions*

Confirm and Mark Specimens Collected During Surgical Procedure*

Utilize Proper Principles with Tissue Handling*

Knowledge of Surgical Would Classifications*

Perform Video Recording/Photography During Procedures*

Experience with Ages

Newborn/Neonate (birth to 30 days)*

Infant (1 month to 1 year)*

Toddler (1 year to 3 years)*

Preschooler (3 years to 5 years)*

School Age Child (5 years to 12 years)*

Adolescents (12 years to 18 years)*

Young Adults (18 years to 39 years)*

Middle Adults (39 years to 64 years)*

Older Adults (64 years to 79 years)*

Elderly Adults (over 79+ years)*

General Surgery

Abdominal Perineal Resection*

Adrenalectomy*

Bowel Resection*

Cholecystectomy*

Colostomy/Ileostomy*

Gastrectomy*

Gastroplasty*

Hemicolectomy*

Colon Resection*

Hepatic Resection*

Herniorrhaphy - Femoral/Inguinal*

Hiatal Herniorrhaphy - Transabdominal*

Pyloric Stenosis*

Nissen Fundoplication*

LeVeen - Peritoneal Shunt*

Hickman/Groshong/Port-A-Cath*

Pancreatectomy*

Organ Procurement*

Radical Mastectomy*

Saphenous Vein Ligation and Stripping*

Splenectomy*

Thyroidectomy*

Tracheostomy*

Whipple Procedure*

Laparoscopic Procedures

Hysterectomy*

Cholecystectomy*

Appendectomy*

Hernia Repair*

Colon Resection*

Gynecology

Caesarean Section*

Dilation & Curettage*

Hysterectomy - Vaginal*

Hysterectomy - Abdominal*

Radical Hysterectomy*

Laser Surgery*

Radium Insertion*

Salpingo-oophorectomy*

Salpingoplasty*

Shirodkar Procedure*

Termination of Pregnancy*

Tubal Ligation*

Vaginectomy*

Vulvectomy*

Vaginal Reconstruction*

Marshall Marchetti*

G.U. and Cysto

Circumcision*

Cystoscopy/ Cystostomy*

Cystectomy*

Hypospadius Repair*

Ileal Loop*

Lithotripsy*

Nephrectomy*

Orchiectomy*

Penile Implant*

Prostatectomy*

Ureterolithotomy*

Ureteroscopy*

T.U.R.P./T.U.R.B*

Vasectomy*

Radical Node Dissection*

Hydrocelectomy*

Orthopedic

Amputation- Leg/ Arm*

Application of Halo Traction*

Arthroscopy/ Arthrotomy*

Closed Pinning & Reduction of Extremities*

Open Reduction Fracture*

Application of External Fixators*

External Compression Devices*

Insertion of Finger Prosthesis*

Carpal Tunnel Release*

Total Joint Replacement - Knee, Hip, Shoulder*

Spinal Fusion-Harrington Rods*

Intramedullary Rodding*

Spica Cast Application*

O.R.I.F. - Shoulder, Hip, Humerus, etc.*

Iliac Crest Bone Graft*

Repair of Dislocation*

Patellectomy*

Tendon Implants & Reanastomosis*

Achilles Tendon Repair*

ACL Repair*

Ligament Repair*

Neurosurgery

Anterior Cervical Fusion*

AV Malformation*

Clipping of Intracranial Aneurysm*

Burr Holes for Subdural Hematoma*

Craniotomy*

Cranioplasty*

Discectomy*

Cervical Laminectomy*

Lumbar Laminectomy*

Meningocele Repair*

Nerve Stimulators*

Shunt Procedures- VP/ VA*

Spinal Procedures/ Fusions*

Plastics

Abdominoplasty/Abdominal Lipectomy*

Augmentation Mammoplasty*

Breast Reduction/ Reconstruction*

Cleft Lip/Palate Repair*

Dermabrasion*

Digital Flexor Tendon Repair*

Face Lift*

Liposuction*

Otoplasty*

Rhinoplasty*

Reduction of Facial Fracture*

Scar Revisions*

Skin Grafting*

Tissue Expanders*

Blepharoplasty*

Eye

Excision of Chalazion*

Cataract Extraction*

Canthotomy*

Correction of Ectropian/ Entropian*

Corneal Transplant*

Enucleation*

I.O.I. Implants*

Lacrimal Duct Probing*

Refractive Keratoplasty*

Repair of Retinal Detachment*

Vitrectomy*

Iridectomy*

Ear, Nose, and Throat

Caldwell-Luc*

Ethmoidectomy*

Frontal Flap Sinus Procedure*

Laryngectomy*

Radical Neck*

Septoplasty*

Sinusotomy*

Tonsillectomy & Adenoidectomy*

Tracheostomy*

Myringotomy*

Mastoidectomy*

Tympanoplasty*

Fenestration Procedure*

Cochlear Implantation*

Stapedectomy*

Nasal Polypectomy*

Laryngoscopy*

Acoustic Neuroma*

Oral

TMJ with Arthroplasty*

TMJ Exploration*

Sagittal Osteotomy*

Endoscopy

Bronchoscopy*

Laryngoscopy*

Colonoscopy*

Esophagoscopy*

Gastroscopy*

Cardiothoracic

Chest Tube Set- Up*

Pneumonectomy/ Lobectomy*

Septal Defect Repair*

Sternal Splitting*

Thoracotomy*

Bronchoscopy*

Lung/Wedge Resection*

Vein Harvesting*

A-V Shunts*

Aortic Aneurysm, Abdominal*

Aortofemoral Bypass*

Graft Insertion*

Cardiac Valve Replacement*

Coronary Artery Bypass Graft- on Pump*

Endarterectomy- Carotid/ Femoral*

Femoral- Popliteal Bypass*

External Temporary Pacemaker*

Internal Pacemaker Insertion*

Intra-Aortic Balloon Pump Catheter*

Port-A-Cath Insertion*

Patent Ductus Repair*

Pericardial Windows*

Portasystemic Shunt*

Repair of Septal Defects*

Thrombectomy*

Vena Cava Ligation*

Vena Cava Filter*

Tracheal Resection*

Esophagectomy*

Heller Procedure*

Transplants

Bone Marrow*

Pancreas*

Heart*

Lung*

Liver*

Multiorgan*

Kidney*

Eye*

Bone*

Skin*

Harvest*

Trauma

Burns*

MVA*

Gun Shot Wounds*

Stab Wounds*

Equipment

Robotics*

Fracture Tables*

Video Systems*

CUSA*

Cell Saver*

PACS Diagnostics*

Electrocautery*

Drills*

Saws*

Stapling Devices*

Cardiac Monitors*

Laser*

Flash Autoclave*

Gastric - Thoracic Drainage Pump*

Bair Hugger*

Blood Warmer*

Chest Tubes*

Dermatomes*

Fiber Optic Laminators*

Argon Beam Coagulator*

Application Agreement

The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Fusion Medical Staffing. Submit this skills evaluation with your initial application. To be updated annually.

By completing this Skills Checklist, you agree to receive calls, AI-generated calls, text messages, or emails from and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at Privacy Policy.