CSFA case studies
CSFA · Put your knowledge to work in context.
The Certified Surgical First Assistant (CSFA) credential is issued by the National Board of Surgical Technology and Surgical Assisting (NBSTSA). NBSTSA describes CSFA professionals as the surgeon's right hand in the operating room-anticipating needs, managing complex tasks, and helping ensure precision at every step, including controlling bleeding, closing incisions, and performing other technical duties. The credential is intended for surgical first assistants who want nationally recognized certification that signals training, professional competency, and commitment to patient safety. The CSFA examination assesses the professional knowledge and skills required for that first-assistant role. The CSFA case studies are 5 cases and about 4,022 words.
1Elective Cholecystectomy in a Poorly Controlled Diabetic Taking a GLP-1 Agonist
R is a 54-year-old man (BMI 38) with type 2 diabetes on metformin and semaglutide 1 mg weekly, scheduled for elective laparoscopic cholecystectomy at 0730 tomorrow. Preoperative values: HbA1c 9.4%, fingerstick glucose 212 mg/dL, potassium 3.4 mEq/L, creatinine 1.1 mg/dL.
758 words, about 4 min2Closing a 12 mm Umbilical Port Site in a Purulent Abdomen
A 34-year-old man (BMI 31) is undergoing laparoscopic appendectomy for perforated appendicitis. Copious purulent fluid and succus were encountered; the surgeon has completed the resection and is now irrigating.
791 words, about 4 min3Wound Separation on Postoperative Day 6 in a Steroid-Dependent Patient
A 68-year-old woman is on postoperative day 6 after an open right hemicolectomy. She takes prednisone 20 mg daily for rheumatoid arthritis.
740 words, about 4 min4Sponge Count Discrepancy at 22:40 With the Surgeon Pushing to Close
A laparoscopic sigmoid colectomy converted to open is in the fascial closure phase. The circulator reports the final sponge count as incorrect: 9 radiopaque sponges counted, 10 documented on the board.
849 words, about 4 min5Anticoagulation, a DNR Order, and a Documented Refusal of Blood Products
A 74-year-old woman with atrial fibrillation is scheduled in 3 days for elective open ventral hernia repair. She takes apixaban 5 mg twice daily; her last dose was this morning.
884 words, about 4 min