Surgical Techniques and Procedures

Course Description

Surgical Techniques and Procedures is a supervised, well-structured laboratory learning experience in the specialized field of operating room services and patient care.

Within the SCNS taxonomy, STS is the Surgical Technology prefix, and the 0000-level number marks this as PSAV clock-hour instruction. Daytona State publishes it at 96 clock hours, offered fall, with STS0003 and STS0155L as corequisites. ⚠ It carries no college credit.

This is the mock operating room: the course where the hands learn what the classroom has described. Together with its 111-hour laboratory it accounts for 207 hours in the first term, and it exists because gowning, gloving, draping, instrument passing, and back table management are motor skills that no amount of reading produces. The skills checked off here are the ones you must already have on the first day of clinical — the operating room is not where you learn to open a glove packet.

Learning Outcomes

Required Outcomes

• Perform the surgical hand scrub to protocol.
• Gown and glove yourself using closed technique.
• Gown and glove another team member.
• Change a contaminated glove during a procedure without contaminating the field.
• Open sterile supplies onto a sterile field correctly.
• Set up a back table in an organised, consistent layout.
• Set up and manage a Mayo stand for a procedure.
• Drape a patient and equipment for a given approach.
• Identify, assemble, and handle basic surgical instruments.
• Pass instruments correctly, firmly, and without looking away from the field.
• Load and pass suture, needles, and blades safely.
• Apply the neutral zone technique for sharps.
• Perform surgical counts with a partner, audibly and accurately.
• Prepare and label medications and solutions on the sterile field.
• Maintain the sterile field throughout a simulated procedure.
• Identify and correct breaks in sterile technique, including your own.
• Position a patient safely with the team for a given procedure.
• Perform skin preparation using correct technique and pattern.
• Handle and label specimens correctly.
• Apply dressings and manage drains.
• Break down a case and manage contaminated instruments and waste.
• Prepare instruments for decontamination and sterile processing.
• Apply operating room safety practice, including electrosurgery and fire safety.
• Function as the scrub role through a complete simulated procedure.

Optional Outcomes

• Perform advanced draping for specialty approaches.
• Set up endoscopic equipment and troubleshoot faults.
• Practise emergency scenarios in simulation.
• Practise robotic setup and instrument exchange.
• Practise team communication and briefing protocols.
• Prepare for clinical skills competency assessment.

Major Topics

Required Topics

• Surgical hand scrub
• Closed gowning and gloving
• Gowning and gloving others
• Contaminated glove change
• Opening sterile supplies
• Back table setup
• Mayo stand management
• Draping technique
• Instrument identification and assembly
• Instrument passing
• Suture, needle, and blade handling
• Neutral zone sharps technique
• Performing counts
• Medications on the sterile field
• Maintaining the sterile field
• Identifying and correcting contamination
• Patient positioning
• Skin preparation
• Specimen handling
• Dressings and drains
• Case break-down
• Decontamination handling
• Electrosurgery and fire safety
• Complete simulated scrub role

Optional Topics

• Advanced specialty draping
• Endoscopic setup and troubleshooting
• Emergency simulation
• Robotic setup practice
• Team communication protocols
• Competency assessment preparation

Resources & Tools

• Surgical Technology for the Surgical Technologist: A Positive Care Approach (AST) — the core text, and the one the CST examination is built around.
• Alexander's Care of the Patient in Surgery — the comprehensive perioperative reference.
• Berry & Kohn's Operating Room Technique — the standard on technique and sterile practice.
• Surgical Instrumentation (Rutherford) — instrument identification, which is largely a memorisation task and needs a good picture reference.
• AST — Association of Surgical Technologists (ast.org) — the professional body; student membership is inexpensive and includes practice materials.
• NBSTSA (nbstsa.org) — free CST examination content outline and eligibility rules; read the eligibility page before you enrol anywhere.
• ARC/STSA (arcstsa.org) and CAAHEP (caahep.org) — free accreditation lookup; verify your programme.
• AORN (aorn.org) — perioperative nursing body whose Guidelines for Perioperative Practice are the standard the whole room works to.
• Flashcards for instruments, and a study partner — unglamorous and the single most effective study method in this programme.
• Anatomy atlas or app — surgical anatomy is approached by region and approach, not by system, and a visual reference helps.
• Your programme's mock operating room and open lab time — gowning, gloving, and draping are motor skills built only by repetition.

Career Pathways

• Surgical technologist — SOC 29-2055.
• Hospital operating rooms — the largest employer, and where most graduates begin.
• Ambulatory surgery centres — a large and growing Florida sector, frequently with better hours than hospital work.
• Specialty services — cardiovascular, neurosurgery, orthopaedics, and transplant; specialisation raises pay significantly.
• Labour and delivery — caesarean section teams.
• Physician offices and specialty clinics performing procedures.
• Central sterile processing — a related pathway with its own certification.
• Travel surgical technologist — substantially higher pay for mobility, once experienced.
• Surgical first assistant — an advanced role requiring further education and separate credentialing (CSFA); the usual route to higher earnings in this field.
• Medical device and instrument sales or clinical support — companies recruit experienced surgical technologists specifically for operating room credibility.
• Programme instruction — teaching in a surgical technology programme after several years in practice.
• ⚠ Progression to nursing, physician assistant, or other licensed roles requires separate degree programmes, and PSAV clock hours generally do not transfer into them — plan the pathway deliberately if that is the goal.

Special Information

⚠ Practise until it is automatic, because attention is a finite resource

• In a real case your attention belongs to the surgeon and the field, not to remembering how to glove. Every skill that is still effortful is attention you cannot spend on the patient.
• Repetition is the entire method. Gown and glove a hundred times. It sounds excessive; it is what competence costs, and it is why open lab hours exist.
• Practise against the check-off sheet, not against your memory of the demonstration — the sheet is what you are assessed on, and it frequently contains steps the demonstration glossed.
• Say the steps out loud while practising. Verbalising is usually graded, and it also embeds the sequence faster.
• Safety items are typically automatic failures — contaminating the field, mishandling a sharp, failing a count. Know which items are automatic failures before the assessment.
• Practise passing instruments with a partner until the pass is firm, decisive, and lands in the hand correctly. A tentative pass is a dropped instrument.
• Practise recovering from errors, not only performing correctly. Contaminating a glove and changing it cleanly under pressure is itself a competency.
• Take corrections without defending yourself. How you receive feedback is assessed, and it is what clinical instructors report on.

⚠⚠ This is a PSAV clock-hour course — it carries no college credit

• The leading zero in the course number is the signal. Under the Florida Statewide Course Numbering System, a 0000-level number denotes postsecondary adult vocational (PSAV) instruction, which is measured in clock hours rather than semester credit hours. These courses carry zero college credit.
• ⚠ A catalog may display the clock-hour figure under a heading that reads "credit hours." It is not credits. When you see a number like 192 or 375 attached to a 0000-level course, that is hours of instruction — no course is worth 375 semester credits.
• PSAV hours do not transfer as college credit to an associate or bachelor's degree, and they do not satisfy general education requirements.
• What they do produce is a workforce credential — a career certificate that qualifies you to sit a national certification examination and to be hired. For many students that is exactly the right outcome, and it is reached faster and more cheaply than a degree.
• Some institutions offer articulation from a PSAV certificate into a related associate degree, sometimes through an articulated credit agreement or a "gold standard" statewide articulation. ⚠ These are institution-specific and change. If your intention is to continue to a degree later, get the articulation in writing from the receiving institution before you enrol, not after you finish.
• Financial aid rules differ for clock-hour programmes. Eligibility, disbursement, and satisfactory-progress rules are not the same as for credit programmes — ask the financial aid office specifically about clock-hour programmes.
• Attendance is the currency. Clock-hour programmes track attendance directly, and hours missed generally must be made up; this is stricter than a typical credit course.

⚠⚠ Surgical conscience: if you break sterility and nobody saw, you say so

• This is the defining professional value of surgical technology, and it is taught from the first day because everything else rests on it.
• Sterility is absolute, not probabilistic. An item is sterile or it is not; there is no "probably fine." When in doubt, it is contaminated.
• You will contaminate something, and the only question is what you do next. Announcing your own break in technique — when no one else noticed and no one would ever know — is the whole of surgical conscience, and it is the single trait that defines a trustworthy surgical technologist.
• The consequence of staying silent is a surgical site infection in a real person. That is not an abstraction; it is prolonged illness, reoperation, and sometimes death.
• Know the boundaries of the sterile field — table height, gown front from chest to sterile-field level and sleeves from cuff up, and never turn your back on the field.
• Monitor everyone. Watching for other people's breaks in technique is part of the role, and saying so out loud is expected of you, not presumptuous.
• Movement discipline matters — sterile to sterile, non-sterile to non-sterile, face the field, and keep hands above waist and below shoulders.
• Verify every package. Integrity, indicators, expiry, and moisture — a wet package is a contaminated package.
• Speaking up is a clinical skill, and programmes assess it. A student who will not say "that's contaminated" to a surgeon is not yet safe to practise.

⚠⚠ Counts — a retained surgical item is a never event

• A sponge, needle, or instrument left inside a patient is classed as a "never event" — an error considered wholly preventable. The count is how it is prevented, and the scrub role owns it jointly with the circulator.
• Counts happen at defined points: before the procedure, before closure of a cavity, at the start of wound closure, and at skin closure, plus whenever staff change.
• Count audibly and together, with both people seeing each item as it is counted. A count performed silently or alone is not a count.
• Never remove counted items from the room during a procedure.
• A discrepancy stops the process. Recount, search the field and the floor, notify the surgeon, and an X-ray is taken if the item is not found. This is not negotiable and not a judgement call.
• Do not let pressure shorten the count. The end of a long case, an impatient team, and an urgent turnover are exactly the conditions under which retained items happen.
• Account for every needle and every blade fragment. Broken instrument tips count too.
• Document counts accurately — the record is the evidence that it was done.
• Emergencies do not remove the obligation; they change how it is managed, and the policy covers that.

⚠⚠ Sharps and bloodborne pathogens — your own safety

• The scrub role handles more sharps than anyone else in the room, and passing them is the highest-risk moment of a procedure.
• Use the hands-free or neutral zone technique. Sharps are placed in a designated basin or magnetic pad rather than passed hand to hand, and both people announce the transfer. This measurably reduces injuries and is the standard of practice.
• Never recap a needle by hand, and never reach into a basin blindly.
• Announce every sharp — "sharp back," "needle," "blade" — every time.
• One sharp on the field at a time where practical, and keep them contained rather than loose.
• Load and unload blades with an instrument, never with fingers.
• Standard precautions apply to every patient, because you do not know who is infectious and neither does the chart.
• Wear the protection: eye protection every case, plus double gloving, which is standard practice in many services and substantially reduces exposure.
• Report every exposure immediately. Post-exposure prophylaxis is time-critical, and students under-report injuries out of embarrassment — do not be one of them.
• Know the surgical smoke and radiation hazards too — evacuate plume, and wear lead when imaging is in use.

⚠⚠ Certification and accreditation — verify before you enrol

• The recognised credential is the CST — Certified Surgical Technologist, awarded by the National Board of Surgical Technology and Surgical Assisting (NBSTSA).
• ⚠⚠ Eligibility to sit the CST examination generally requires graduation from a programme accredited by CAAHEP (through the ARC/STSA) or ABHES. Confirm a programme's accreditation before enrolling — this is the same trap as CAPTE for physical therapist assistants, and it is unrecoverable after the fact.
• Accredited programmes require a documented minimum number of surgical cases before graduation, commonly cited as 120, distributed across specialties and roles. Keep your case log meticulously and from the first day — reconstructing it later is difficult and sometimes impossible.
• Most employers require certification even where the law does not, and many require it within a set period after hire.
• Certification is maintained by continuing education or re-examination on a defined cycle.
• ⚠ State regulation of surgical technologists varies and has changed in several states. Florida has not historically licensed surgical technologists as a separate licensed profession in the way it licenses nurses or physical therapist assistants, but requirements set by statute, by facility, and by accreditor do change.
• ⚠ Rule 11 applies. Verify current certification, accreditation, and any state requirements directly with NBSTSA, the accreditor, and the Florida Department of Health rather than relying on any course guide, including this one.
• Background screening and drug testing are required for clinical placement, and a criminal record can end a career pathway before it starts — raise any concern with the programme early and privately.

⚠ Clinical placement requirements — sort these out early

• Health clearance and immunisations are required before you may enter a clinical facility — typically hepatitis B, MMR, varicella, tetanus, an annual influenza vaccination, and tuberculosis screening.
• Level 2 background screening and drug testing are standard for Florida health care placements, and a facility may refuse a student it declines to screen.
• Current BLS certification is normally required, from a provider the programme accepts.
• You travel to the affiliate, and placements are assigned rather than chosen. Transport is your responsibility, and a Florida clinical affiliate can be a substantial drive.
• Clinical hours are unpaid and follow the operating room's schedule, not a class timetable — expect early starts, full days, and occasional late finishes when a case runs long.
• Plan employment and childcare around the rotation, not the other way round. This is the single most common reason students struggle in the clinical terms.
• Professional behaviour is assessed continuously, and a facility may remove a student for conduct without a right of appeal to the college.
• You are a guest and a learner, not staff. Work within your role, ask when unsure, and never exceed what you have been checked off to do.
• HIPAA applies fully. No phones in the operating room, no photographs, and no discussion of cases outside the clinical team — a social media post about a case ends placements and careers.

⚠ The physical and psychological demands are real

• You stand still for hours. Long cases mean sustained standing in one position, frequently with arms elevated, and it is more fatiguing than moving work. Supportive footwear and compression stockings are a genuine professional investment.
• You lift. Instrument trays are heavy, and patient positioning and transfers are part of the job — use the equipment and the team.
• Operating rooms are cold, and you will be gowned and gloved for hours without the ability to adjust anything.
• Bathroom and meal breaks are constrained by the case, which surprises students more than anything else. Hydrate and eat before a long list, sensibly.
• Radiation exposure occurs when imaging is used intraoperatively — wear lead, use distance, and monitor with a dosimeter where provided.
• Latex and chemical sensitivities matter here; disclose them to the programme early.
• You will see trauma, and some cases end badly. Paediatric cases and unexpected deaths affect experienced staff, and it is normal to be affected. Know what support the programme and the facility provide, and use it.
• The culture can be blunt under pressure. Sharp instruction during a critical moment is about the case, not about you — but genuine abuse is not acceptable, and there is a route to report it.

STS0155 is 96 clock hours, offered fall, with STS0003 and STS0155L as corequisites — all three run together. ⚠ Clock hours carry no college credit.

Expect skills competency check-offs, typically pass-or-repeat with automatic-failure safety items, rather than percentage grades. See this repository's STS0155L guide for the paired laboratory.