Generic elementary technical skills: PGY 1-2
The following table is an extract from the Essential Surgical Skills (ESS) document produced by the College that describes the skill sets that should be developed during both PGY 1-2 years. These are required for surgical training, but are broadly relevant to other procedural careers.
Standard precautions – barriers, sterile techniques and safety
Principles of standard precautions
- Infection control
- Safe management of sharps
Personal protection
- Scrubbing
- Gowning
- Gloving
- Splash protection
Standard precautions video
Instrumentation
Scissors
- Able to name types of scissors and explain indications for appropriate and safe use
- Safe and correct handling and use
- Explain mechanism of action of scissors
- Demonstrate care of scissor blades
- Able to pass and receive scissors safely
Needle holders
- Select needle holder of appropriate weight and length
- Safe and correct handling and use
- Pass and receive needle holders safely
Tissue-holding forceps
- Selection of appropriate forceps (thumb – unlocking; locking; tooth and non-tooth)
- Safe and correct handling and use
Retractors
- Selection of appropriate retractors (hand-held; self-retaining)
- Safe, correct handling; use and risk of tissue damage
Scalpel
- Select appropriate blade
- Safe and correct mounting of blade
- Able to explain principles of holding and using
- Able to pass scalpel safely using a safety dish
- Perform a long cut with square edges at appropriate depth, without slicing or multiple passes
Skin staples
Recognise indications for use of skin staples
- Correct application
- Safe removal
Instrumentation video
Using sutures, surgical knots, needles
Suture needles
- Correct mounting on needle holder
Knot tying, principles and practise
- Selection of appropriate materials
- Knot security
- Able to tie a square knot proficiently: instrument technique; one-handed technique; two-handed technique
Knot tying and suturing video
Surgical wounds and tissue handling
Conform to principles of wound management
- Dressing
- Debridement
- Wound closure: healing by primary intention
Insertion and care of tubes and drains
Describe principles of use of tubes and drains
- Indications for safe use
- Complications and drain security
Safely insert and/or take out:
- Nasogastric
- Nasoenteric
- Intercostal catheter – underwater seal drains
- Urethral catheter
- Arterial access
- Venous access: peripheral
Splinting and immobilisation
Describe indications for immobilisation
Prevention of complications
- Selection of appropriate materials
- Pressure point
- Compartment syndrome
Correct and safe application
- Limb splint
- Plaster of Paris – upper limb/lower limb
- Skin traction
- Hand splints
- Cervical and axial immobilisation
Local anaesthetic (dermal and subcutaneous)
Safe and appropriate use of local anaesthetic agents for minor procedures
- Wound infiltration
- Skin infiltration
- Digital nerve blocks
Selection of appropriate agent
- Short-acting
- Long-acting
- Vasoactive agents
Pharmacokinetics
- Dosage
- Duration of action
Adverse effects and management
- Local injury
- Systemic effects
Peri-operative life support
Basic airway management
- Clearing the airway/guide airway
- Oxygen delivery
- Bag mask ventilation
- Laryngeal mask or intubation, if trained
Oxygen delivery
- Nasal prongs
- Mask
- Reservoir mask
- CPAP
- Recognise indications for circulatory support
Safe practices for circulatory support
- Emergency venous access
- Monitoring and assessment
- External haemorrhage control
- IV fluid resuscitation
- Transfusion of blood
- Transfusion of blood products
- Management of complications
- Prevention of hypothermia