Professional Practice, Safety, and Administrative Duties
Scope, documentation, and rights
Professional practice rests on scope of practice, credentialing, and clear documentation. Know what your state and facility allow; the first assistant does not independently obtain consent, prescribe, or diagnose. Document objective findings, counts, specimens, implants, and communication. Protect privacy under HIPAA and honor patient rights, advance directives, and cultural preferences. Use SBAR for handoffs and speak up when a safety concern arises-“stop the line” is expected, not optional.
OR safety systems
The fire triad requires an oxidizer (oxygen or nitrous oxide), fuel (drapes, alcohol prep, hair), and an ignition source (electrocautery, laser). Prevent fires by allowing alcohol prep to dry fully, using wet towels, and keeping oxygen away from the field. Follow sharps safety: never recap by hand, use neutral zones, and report exposures immediately-wash the area, report, and follow post-exposure prophylaxis. Electrical and laser safety, PPE, and bloodborne-pathogen precautions are mandatory.
Quality and administrative duties
Participate in time-outs, count reconciliation, specimen labeling, and incident reporting. Sentinel events and near misses are reviewed through quality improvement; report factually, not punitively.
Trap: a question may suggest alcohol prep is safe if “mostly dry,” or that a sharps injury should be kept quiet.
Rule of thumb: “oxidizer, fuel, ignition-remove one leg of the triad.”