CSFA key terms

The habit of doing the right thing in the operating room even when no one is watching, such as immediately reporting a break in sterile technique or a possibly retained item.

A brief pause before incision in which the whole team verbally confirms the patient's identity, the procedure and site, consent, allergies, and any special equipment needs.

The patient's voluntary agreement to a procedure after being told its purpose, risks, benefits, and alternatives; the signed form documents that discussion but does not replace it.

Visible marking of the operative site by the surgeon while the patient is awake, used for laterality and spinal level so the team can confirm the correct location at the time-out.

The period before anesthesia during which a patient takes nothing by mouth, reducing the risk of vomiting and aspiration at induction; orders follow published fasting intervals.

An antimicrobial given within a defined window before incision, chosen for the organisms likely in that procedure, to lower the chance of a surgical site infection.

Preparing the skin with an antimicrobial agent applied in widening circles from the incision outward and allowed to dry fully, reducing organisms on the operative surface.

Removing hair at the operative site with electric clippers immediately before surgery rather than shaving with a razor, because nicks and abrasions raise infection risk.

Measures that prevent clots forming in leg or pelvic veins around surgery, including compression devices, early walking, and anticoagulant drugs ordered by the surgeon.

A rare inherited reaction to certain anesthetic gases and succinylcholine that causes rapidly rising temperature, rigid muscles, and acidosis; it is treated emergently with dantrolene.

Placing and padding the patient on the table so the planned approach is possible while protecting nerves, skin, eyes, and breathing; the first assistant helps with safe transfer and alignment.

The area of drapes and equipment that must stay free of microorganisms; only sterile items touch it, and anything questionable or below table level is treated as contaminated.

The scrub before gowning that reduces resident and transient organisms on the hands and forearms, using an antimicrobial agent and friction for the required contact time.

Current passes from a small active electrode through the patient to a large return pad on the skin to cut or coagulate; pad contact and placement must be checked to prevent burns.

Current travels only between the two tips of forceps, heating just the tissue grasped between them; it is preferred near delicate structures and needs no patient return pad.

Stopping or preventing bleeding by pressure, clamping, ligation, cautery, or topical agents; the first assistant keeps the field clear by anticipating and controlling bleeders.

Suture material broken down by the body over weeks to months, such as polyglactin or chromic gut, chosen for tissue that heals quickly or where removal would be difficult.

Tying a knot with a needle holder while the free ends are managed by hand, used when the wound is deep or the suture is short; throws must be square and snug without strangling tissue.

Holding back skin, muscle, or organs to expose the operative area with hand-held or self-retaining instruments, while avoiding crushing or prolonged pressure on nerves and vessels.

A cuff that temporarily blocks blood flow to a limb to create a dry field; inflation time is documented and time limits are observed to prevent nerve and muscle injury.

A tube placed to carry fluid or air out of a wound so it does not collect; output, patency, and security are checked and recorded regularly.

Tissue removed during surgery that is sent for laboratory study; it is handled with a clean instrument, placed in the correct container and fixative, and labeled with patient identifiers in the room.

A simultaneous verbal count of sponges, needles, and instruments by the circulator and scrub person at set points including before closure, with any discrepancy resolved before the patient leaves.

A fire on or in the patient that requires fuel, an oxidizer such as oxygen, and an ignition source such as cautery; prevention includes letting alcohol prep dry and keeping oxygen away from the field.

An accidental needlestick or cut from a contaminated sharp; the wound is washed, the exposure reported immediately, and source testing and prophylaxis started per protocol.

Everyday infection-control practices used for all patients, including hand hygiene, gloves, gowns, masks, and eye protection whenever contact with blood or body fluids is likely.

A structured way to pass patient information using situation, background, assessment, and recommendation, used when transferring a patient from the operating room to recovery to prevent lost or garbled details.

An infection of the incision or deeper tissue within a defined period after surgery, recognized by redness, warmth, drainage, pain, or fever and classed as superficial, deep, or organ space.

Separation of a closed wound, often from tension, poor healing, or infection; superficial layers may open alone, while full-thickness opening with protruding bowel is an emergency.

A collection of clear serum under the skin at a closed wound that causes soft swelling and may need aspiration; if it persists it can become a site for infection.

A sealed dressing attached to suction that removes fluid and draws wound edges together, used for open or poorly healing wounds; the seal, pressure setting, and output are monitored.

Taking out external sutures or staples once the wound has gained enough strength, at times that vary by body site and patient factors, using sterile technique and confirming all pieces are removed.

The surgeon's formal record of the procedure, findings, specimens, counts, and complications; it guides postoperative care and supports billing and legal review.

The duties a surgical first assistant may legally perform under state law, facility policy, and the supervising surgeon's delegation; it varies by location and care setting.

An empty pocket left when tissue layers are not brought together, which fills with blood or serum and invites infection; closing it means approximating each layer during closure.

A surgical connection between two hollow structures such as bowel ends; the assistant keeps the field clear, maintains alignment, and helps avoid tension or twisting as it is built.

Keeping the CSFA credential current by recertifying before the expiration date and completing the required continuing education, which documents ongoing competence.