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



  • 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


  • Selection of appropriate retractors (hand-held; self-retaining)
  • Safe, correct handling; use and risk of tissue damage


  • 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


  • 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