NBSTSA Certified Surgical Technologist Course Notes

High-yield preop: verify patient/procedure/site and documentation; review the preference card; resolve allergies/discrepancies; confirm equipment, instruments, accessories and backups; prepare a clean controlled OR; inspect sterile packages; open aseptically; perform correct hand/surgical antisepsis and sterile setup. Preoperative Preparation accounts for 19 scored items in the current blueprint.

• Treating a preference card as more authoritative than patient-specific safety information.

• Preop questions reward verify-before-open and stop-and-clarify thinking.

The largest subdomain: 68 scored items. Master aseptic technique, counts, positioning/prep/draping, instruments and procedural sequence, hemostasis, suction/irrigation, medications, implants/grafts/specimens, drains, emergencies, sutures/staples and dressings. Most questions are 'what should the CST do next/first' decisions under sterile-field and patient-safety constraints.

• Continuing after a known or suspected sterile-field breach.

• Intraoperative questions are heavily sequential: anticipate the next tissue layer, instrument, hemostatic need, closure step, or device setup.

Postoperative Procedures account for 10 scored items. Safely remove drapes/equipment, clean and inspect the patient, report abnormalities and measured blood/solution data, coordinate transfer, dispose of sharps/waste correctly, perform debrief/turnover, contain contaminated instruments, and restore room/supply readiness.

• Shaking contaminated drapes or losing track of sharps/items during field breakdown.

• Think: patient first, then containment, communication, transfer, decontamination/turnover.

Administrative/Personnel accounts for 7 scored items. Keep preference cards current, reduce waste without reducing safety, follow disaster plans, recognize fire/chemical/laser/smoke/electrical hazards, protect privacy and patient rights, communicate effectively across cultures and teams, and precept/mentor without allowing unsafe practice.

• Making undocumented preference-card changes or deleting backup capability solely to save cost.

• Safety beats cost when the two conflict.

Equipment Sterilization/Maintenance accounts for 16 scored items—the heavier Ancillary subdomain. Know cleaning before sterilization, point-of-use care, safe contaminated transport, inspection/testing/assembly, Spaulding classification, mechanical/chemical/biological monitors, Bowie-Dick testing, implant-load BI guidance, sterile-storage integrity, preventive maintenance and removal of failed equipment from service.

• Skipping cleaning because an item will be sterilized.

• Reprocessing follows the device IFU and the cleaner/sterilizer IFU; do not invent universal settings.

Anatomy & Physiology accounts for 18 scored items. Study anatomy as surgical relationships, not isolated vocabulary: named structures, layers, vessels/nerves at risk, and system function during surgery. Cover cardiovascular, GI, GU, integumentary, lymphatic, muscular, neurologic, ophthalmic, ENT, peripheral vascular, pulmonary, reproductive and skeletal systems plus common pathology.

• Memorizing body-system facts without relating them to the procedure in the stem.

• Visualize the operation and trace what the surgeon must identify, divide, retract, protect or anastomose.

Microbiology accounts for 6 scored items. Know organism categories/pathogenesis, chain of infection and exposure routes, Standard Precautions/asepsis, cleaning before sterilization, tissue handling, surgical wound classification, wound-healing phases and host/tissue factors that increase infection risk.

• Confusing bacteria with viruses or chemical indicators with spore-based biological indicators.

• Use the chain of infection to reason from agent/reservoir/route to the control measure.

Surgical Pharmacology accounts for 6 scored items. Know common perioperative drug categories and anesthesia methods, medication identity/labeling, concentration/dilution/dose math, solutions/hemostatic products, interactions/adverse events including malignant hyperthermia, and safe maximum-dose awareness without assuming one universal limit.

• Confusing anesthesia with analgesia or drug category with the reason it is used perioperatively.

• Medication safety starts with name + concentration + requested amount before the item reaches the field.