Please Help...Surg Tech Questions

HeatherB,CST · Oct 27, 2007

hi JHFaith! I would try the AST forums again, I'm sorry you had trouble. I just logged on and they are up right now. You will get many good answers here, but all of these topics have been covered in great detail in the AST archives. I am a current ST student, but I can maybe get the ball rolling with a few answers.

1. I have not had the Pharm portion yet, but in my program (2-yr ST degree) Mathematical Measurements was required as a pre-req. Algebra was a pre-req of MM.

2. These nurses here would be better able to answer that. I believe STs verify the med/dose with the nurse and pass it if necessary.

3. Again, I'd rather one of these folks answer.

4. Some STs do foleys, the state or facility policy will determine that.

5. Some STs learn suturing, they can sometimes close skin only, sometimes subQ and facia, usually one must be trained as a CFA (first assist) in order to close. This seems to vary greatly by state and facility. It seems to me that in the small hospitals, the STs do the most. Big uni hospitals, there are medical students/surgical PAs/etc. who close. We all learn the gazillion different sutures.

6. At first, you learn the procedures in school. As you see them done in clinicals, it starts to click in your head. After scrubbing a case once or twice, it gets easier, and before you know it, you just know it. From what they tell me, it's always prudent to study up on any unfamiliar procedures before you get in there. Yes, we need to know as much about the steps in the surgery as the doc, we just don't have the theory behind it that they do.

Best of luck to you! I hope you are able to get logged into the AST forums, if you cannot, pm me and I will get it sorted out for you. Both forums, ast and allnurses, have been invaluable for me. I am much more prepared going into my program, and have a definite edge.

JHFaith · Oct 27, 2007

Thank you for your reply CSTwannabe! I really appreciate your input. I plan on starting the surgical technologist program soon so I'm trying to find out as much as I can before it starts so I know my decision to start the program is right. It is hard to know if you really want to do something when you don't have all the facts! Thanks Again!!!

zerby1470 · Oct 28, 2007

I can help you with a few of these..

1 & 2. Basic math, ratios etc. For example, doc wants hep lock flush 100 units per CC of injectable saline. You facility is out of flush but does have 1000 units per cc which you can dilute in saline. Straight forward math, but mistakes can kill people. The surgeon tells you the dose they want. You MAY have to calibrate the proper dose, and you state what you are passing to the doc before giving it to them.

3. It depends. You keep your back table sterile, which can be complicated sometimes. If a code happens while the pt is open and the code is successful, you need sterile supplies to finish the

procedure. Beyond that, it is dependent on the situation. You may white on your table what and when things happen until someone non sterile arrives to take over that role. You may have to relieve on compressions. If you are not in the sterile role at the time of the code, you may be a gofer, to get the code cart, other personnel, supplies, etc.

4. Depends on your facility and state. CAAHEP accredited schools are required to teach caths, but your facility dictates whether it is within your scope or not. More essential, you never place one unless you are properly trained. If you learn it in school, but don't do one for 10 years, you are not necessarily competent to place one so it would likely fall out of your scope.

5.In school, you will learn different types of sutures and needles as well as what they are used for. You may be trained to suture sub-q. Whether you can or not again depends on your state and facility. At mine, CST's that have been through workshops and been precepted by a surgeon can close sub q and skin for that doc while the doc is in the room, but not necessarily sterile. Again, if your competency is not there...you don't do it. It is not in the best interest of the patient.

6. In school you will learn the basics for basic procedures. For example, if you pass a suture, they will probably need a forcep to grab tissue and a scissors to cut the suture. Once at clinical (but still in school), you will learn the rhythm of various procedures. That is when you begin to learn the anticipation of instrumentation, as well as troubleshooting. You do learn the steps and anatomy of many procedures as well as enough knowledge to make a reasonable guess on many unfamiliar ones. It's a lot to learn, and very focused learning.

You do need a thick skin to work in the OR, as well as the ability to speak up if something is not right. As far as the liability/responsibility issue, I would love to see nothing more than requiring CST's/ST's to be licensed. It would allow for another verification that the people in your loved ones surgery are properly trained. Many CST's are, but not all. Many have no desire to be nurses, but that should not affect change their liability or responsibility to the patient.

Sorry that this was so long. Hope that helps!

HeatherB,CST · Oct 28, 2007

Great info, zerby!

JHFaith · Oct 29, 2007

Zerby1470, thank you for the information. I appreciate your reply.

ewattsjt · Oct 30, 2007

hi jhfaith, i am not trying to flame you but this really isn't the board to be posting on for cst information. i realize the ast forum was down but it isn't often and when it does occur, it is up within a couple of hours. since it is already posted and answered, i will throw my 2 cents in.

my answers will run very close to what zerby has already stated. state law and facility policy play a big role in the answers you are seeking. some places will say no to my answers but where i work; my answers are correct. you will have to check your state laws and facility policies. where there is no state law or facility policy, a court of law will look at the standard which will be the aorn standard. having said this, even as a cst you need to familiarize yourself with the aorn standards.

the national board of surgical technology and surgical assistants exam is a national exam and not area specific so you may do things in school that you will never be allowed to perform where you reside. therefore you need to know how to do things that is acceptable in other areas in case you move and/or because it may be on the exam.

1&2) these answers go hand in hand. we had the same pharm as nursing. the idea is that since you are the last to pass it to the surgeon, you need to know what you are passing and what it does. we also become a fail safe or safety net for the nurses. i have caught wrong doses errors and was able to correct it before it was passed off to the surgeon (it is a team effort). the rn always needs to see what was mixed if you are mixing meds. the most common drug that you may have to mix will usually be heparin. soooo....yes there was a lot of math involved in calculations of dosages. there was also a lot of memorization of the drugs, doses, routes, their effect and contraindications.

3) it depends on the situation and how many people are there. your job as a cst is to maintain a sterile back table to finish the procedure or close if at a point where you can. if there are not enough people in the room, your job shifts as the life of the patient is always the primary concern.

4) that goes back to area specific. i can place a foley under the delegation of an rn. we always provide an assistant to the surgeons, so until it is time to scrub, the assistant will second circulate. within the same token, a friend of mine used to work at a facility in delaware. he was a certified first assistant. he was not allowed to place foleys. this shows you the importance of finding out what your state laws and/or facility policies state.

5) as a st/cst not only are you to know the different types of suture, but you need to have a basic understanding of the needles. let's say you have four 3-0 vicryls on different needles, and the doc asks for a 3-0 vicryl stat. you need to know what needle does what and is used for what.

a st/cst being allowed to close goes back to laws and policies as well as being trained. my facility allows csts to close sub-q and skin only, if they have gone through an approved wound closure work shop and have been precepted by the surgeon they are closing for. the surgeon is not allowed to leave the or suite.

6) part of the basic anticipation is learned in clinical rotations and the rest is learned through experience. that is one reason the clinicals are so long; if you are in an associate degree program, the last two semesters of your classes should be all surgical procedures. i have never thrown away or sold any of my books because they can be reference materials for cases we do not do very often. looking up unfamiliar procedures will aid in your anticipation of the surgeon's needs.

hope this helped you!

JHFaith · Nov 4, 2007

Thank you ewattsjt for the useful information. I understand this isn't the best forum to get information about surgical technology but I knew some of you out there would be able to help me. I still cannot get access to the message boards on the AST website. I have gone through the free registration process more than once and I always get a prompt stating that the administrator has denied access and I will be notified further in an email. I have not gotten a response in an email and I have even emailed the site twice asking when I will be able to successfully register. Until then I'm searching this website for useful information. BTW, I also googled surgical technology message boards and only found one other and that one was not kept up to date. Thanks again for your reply!

ewattsjt · Nov 4, 2007

there are different places you can email the site. you can send me a private message. i can not give his email here without his expressed permission.

in case you didn’t know….another thing you may try to do is to clear all history in your computer. open a web page, click on tools, then internet options. the new window will have a delete history, delete cookies, and delete temporary files. delete all of these and you should regain access unless they are blocking you by using your ip address.

i hope one of these works for you.

JHFaith · Nov 6, 2007

Thanks ewattsjt for your help with the AST message boards. Just a few minutes ago I was able to access the message boards. I'm going to read through some of the posts soon and I hope to learn a lot. Thanks again. Take Care!