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Positioning the patient

A. The surgeon shall convey the exact position that will give the best exposure for the surgical procedure. The surgical assistant will carry out this order. Consideration will be given to the patient’s comfort and safety.

B. Points of pressure shall be padded: elbows, heels, knees, eyes, face, and axillary region.

C. Circulation shall not be impaired. (A tourniquet may be required for some procedures.)

D. Nerve damage shall be guarded against.

E. The temperature of the patient should be discussed with the anesthesia personnel and methods employed to maintain the desired temperature range.

F. The surgical assistant shall be familiar with common positions related to the surgical procedure and will be able to use the equipment necessary to provide the position. Competencies will include the following:

                  1. Fracture tables

                  2. Head stabilizers

                  3. Body stabilizers

                  4. C-arm extensions

                  5. Any other equipment needed

G. Upon completion of the procedure, the patient shall be evaluated for any possible damage from positioning which will include assessment of the skin. The abnormal condition shall be reported to the surgeon and treatment and documentation shall be carried out.

Providing visualization of the operative site by the following:

A. Appropriate placement and securing of retractors with or without padding

B. Packing with sponges

C. Digital manipulation of tissue

D. Suctioning, irrigating, or sponging

E. Manipulation of suture materials (e.g., loops, tags, running sutures)

F. Proper use of body mechanics to prevent obstruction of the surgeon’s view

3. Utilizing appropriate techniques to assist with hemostasis

1. Clamping and/or cauterizing vessels or tissue

2. Tying and/or ligating clamped vessels or tissue

3. Applying hemostatic clips

4. Placing local hemostatic agents

B. Temporary

1. Applying tourniquets and demonstrating awareness of the indications/contraindications for use with knowledge of side effects of extended use.

2. Applying vessel loops

3. Applying non-crushing clamps

4. Applying direct digital pressure

4.   Participating in volume replacement or auto-transfusion techniques as appropriate

5.   Utilizing appropriate techniques to assist with closure of body planes

A.  Utilizing running or interrupted sutures with absorbable or non-absorbable material of wound layers, including muscle and fascia.

B. Utilizing subcuticular closure technique with or without adhesive skin closure strips

C. Closing skin with method per surgeon’s directive (suture, staples, etc.)

D. Postoperative subcutaneous injection of local anesthetic per surgeon’s directive

 6.  Selecting and applying appropriate wound dressings, including the following:

A.  Liquid or spray occlusive materials

B.  Absorbent material affixed with tape or circumferential wrapping.

C.  Immobilizing dressing (soft or rigid)

7.  Providing assistance in securing drainage systems to tissue

8.  Performs other duties as required

9.  Maintains established hospital policies, procedures, directives, quality, safety, environmental and infection control standards appropriate for this position

DIRECTION/SUPERVISION OF OTHERS - None

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law.

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