Surgery End of Rotation ™ Exam Blueprint & Topic List

The Surgery End of Rotation™ (EOR) exam is one of the PA Education Association’s objective, standardized evaluations and is intended to serve as one measure of the medical knowledge PA students gain during their supervised clinical practice experience. This article outlines the current PAEA Surgery EOR Exam Blueprint, including its content areas, task areas, and perioperative setting targets, and presents the Exam Topic List. The specifications presented here reflect the current Surgery Blueprint and Topic List published by PAEA as of July 2026. Questions on an examination represent only a sample of the content that may be assessed and may not reflect every topic identified in the Topic List. Exam candidates and clinical coordinators are encouraged to review the original Blueprint, Topic List, and Core Tasks and Objectives through PAEA’s End of Rotation™ Blueprints and Topic Lists resource page at https://paeaonline.org/assessment/end-of-rotation/blueprints-and-topic-lists. ^[1]

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the PAEA Surgery End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are created and owned by PAEA®. The surgery-specific "Knowledge of" and "Skill in" descriptions, perioperative study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]

Content Categories

Task Categories

Perioperative Settings

* Each End of Rotation™ exam contains 120 multiple-choice questions, including 100 scored questions and 20 unscored pretest questions. The Blueprint percentages apply to the 100 scored questions. The Surgery Blueprint is organized by both content area and task area, and Professional Practice is one of its seven task areas. The perioperative percentages represent targets across the content and task areas.

General study approach

• Use the Blueprint percentages to set relative study priorities rather than to exclude lower-percentage categories.
  • Gastrointestinal, cardiovascular, and pulmonary/thoracic surgery together account for 45% of the scored questions, and the five largest content categories account for 65%; however, every listed category remains testable.
  • Diagnosis and Clinical Intervention together account for 40% of the scored questions, emphasizing the need to move beyond factual recall and practice selecting the most likely diagnosis and the most appropriate next step.
• Surgery End of Rotation™ questions cover the full lifespan and may be set in ambulatory, emergency department, inpatient, and perioperative care. Preparation should therefore not be limited to adult inpatient surgery or operating-room care.
• End of Rotation™ questions use a one-best-answer clinical-vignette format intended to assess higher-order thinking. Study each condition through its typical presentation, key distinguishing findings, appropriate diagnostic evaluation, initial management, indications for surgical intervention, and important perioperative complications.

Content Categories

Gastrointestinal diagnoses

• Anal disorders
• Appendicitis
• Bowel obstruction
• Cholecystitis/cholelithiasis
• Diverticulitis
• Gastrointestinal bleeding
• Hiatal hernia
• Ileus
• Inflammatory bowel disease
• Malignancy of the gastrointestinal tract
• Obesity
• Pancreatitis
• Peritonitis
• Toxic megacolon

Perioperative gastrointestinal risk assessment and complications

Gastrointestinal procedures

• Abdominal drains
• Colonoscopy
• Endoscopic retrograde cholangiopancreatography
• Endoscopy
• Ileostomy
• Nasogastric tubes
• Parenteral nutrition
• Percutaneous endoscopic gastrostomy tube

Cardiovascular diagnoses

• Acute arterial occlusion
• Aortic aneurysm
• Aortic dissection
• Chronic arterial insufficiency
• Chronic venous insufficiency
• Compartment syndrome
• Coronary artery disease
• Carotid artery stenosis
• Intestinal ischemia
• Renal vascular disease
• Valvular heart disease
• Varicose veins

Perioperative cardiovascular risk assessment and complications

Cardiovascular procedures

• Advanced cardiac life support
• Arteriovenous fistula placement
• Central line placement
• Permacath/port placement
• Vascular access

Pulmonary/thoracic surgery diagnoses

• Chylothorax
• Empyema
• Hemothorax
• Lung malignancy
• Mediastinal disorders
• Pleural effusion
• Pneumothorax
• Pulmonary nodule

Perioperative pulmonary/thoracic surgery risk assessment and complications

Pulmonary/thoracic surgery procedures

• Chest tube
• Thoracentesis

Breast surgery diagnoses

• Breast abscess
• Benign breast disease
• Carcinoma of the female breast
• Carcinoma of the male breast
• Disorders of the augmented breast
• Fat necrosis
• Mastitis
• Phyllodes tumor

Perioperative breast surgery risk assessment and complications

Breast surgery procedures

• Biopsy

Dermatologic diagnoses

• Burns
• Cellulitis
• Dermatologic neoplasms
• Epidermal inclusion cyst
• Hidradenitis suppurativa
• Lipoma
• Pressure ulcer

Perioperative dermatologic risk assessment and complications

Dermatologic procedures

• Aspiration of seroma/hematoma
• Incision and drainage of abscess
• Skin biopsy
• Skin graft and flap
• Suturing

Renal/genitourinary diagnoses

• Benign prostatic hyperplasia
• Nephrolithiasis
• Paraphimosis/phimosis
• Testicular torsion
• Urethral stricture
• Urologic/renal neoplasms

Perioperative renal/genitourinary risk assessment and complications

Renal/genitourinary procedures

• Lithotripsy
• Urinary catheterization
• Vasectomy

Trauma/acute care diagnoses

• Acute abdomen
• Alteration in consciousness
• Compound fractures
• Shock

Perioperative trauma/acute care risk assessment and complications

Trauma/acute care procedures

• Transfusion

Neurologic/neurosurgery diagnoses

• Carpal tunnel syndrome
• Epidural hematoma
• Neurologic neoplasms
• Subarachnoid hemorrhage

Perioperative neurologic/neurosurgery risk assessment and complications

Neurologic/neurosurgery procedures

• Lumbar puncture

Pain medicine/anesthesia diagnoses

• Acute pain
• Chronic pain
• Substance use disorder

Perioperative pain medicine/anesthesia risk assessment and complications

Pain medicine/anesthesia procedures

• Endotracheal intubation
• Intravenous line placement
• Local and regional anesthesia

Endocrine diagnoses

• Adrenal disorders
• Endocrine neoplasms
• Parathyroid disorders
• Pituitary disorders
• Thyroid disorders

Perioperative endocrine risk assessment and complications

Endocrine procedures

• Fine needle biopsy

Task Categories

*AMBOSS editorial study guidance: The following surgery-specific "Knowledge of" and "Skill in" descriptions were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source.

• Knowledge of:
  • General surgical and perioperative history and physical examination components and techniques
  • Pertinent medical, surgical, family, medication, allergy, anesthesia, bleeding, thrombotic, and substance-use history
  • Risk factors for surgical disease, operative complications, infection, impaired wound healing, and venous thromboembolism
  • Significant vital-sign abnormalities and physical examination findings in surgical patients
  • Signs and symptoms of acute surgical conditions and common postoperative complications
• Skill in:
  • Reviewing pertinent resources to conduct comprehensive and/or problem-based interviews and physical examinations with compassion and empathy
  • Identifying pertinent historical information from patients, caregivers, medical records, and emergency personnel
  • Identifying pertinent abdominal, cardiopulmonary, vascular, neurologic, breast, genitourinary, skin, wound, and extremity examination findings
  • Assessing hemodynamic stability, hydration, perfusion, pain, and general clinical appearance
  • Evaluating surgical wounds, incisions, drains, ostomies, and operative sites
  • Triaging patients based on abnormal vital signs, examination findings, mechanism of injury, and/or general observations
  • Recognizing findings that require urgent stabilization, surgical consultation, or operative intervention
  • Reassessing postoperative patients for evidence of deterioration

• Knowledge of:
  • Patient- and family-centered education related to diagnostic and laboratory studies
  • Indications, limitations, risks, contraindications, techniques, and potential complications of commonly used diagnostic and laboratory studies
  • Selection of appropriate preoperative testing based on the planned procedure, comorbidities, functional status, anesthesia risk, cost, probable yield, invasiveness, and potential effect on management
  • Expected postoperative laboratory and imaging findings
  • Findings suggestive of surgical or postoperative complications
• Skill in:
  • Collecting diagnostic and laboratory specimens
  • Communicating indications, risks, benefits, preparation requirements, and results effectively to members of the healthcare team
  • Communicating indications, risks, benefits, preparation requirements, and results effectively to patients, families, and caregivers
  • Integrating diagnostic and laboratory results with the history, physical examination findings, and perioperative course
  • Reviewing and interpreting laboratory studies, imaging, electrocardiography, endoscopy, and vascular studies
  • Selecting appropriate initial and subsequent diagnostic and laboratory studies
  • Monitoring clinically relevant laboratory and physiologic trends
  • Recognizing results that require urgent intervention, surgical consultation, or additional diagnostic evaluation
  • Using diagnostic equipment safely and appropriately

• Knowledge of:
  • Significance of diagnostic and laboratory studies as they relate to surgical diagnoses and perioperative complications
  • Significance of the patient’s history, operative history, risk factors, and clinical course as they relate to the differential diagnosis
  • Significance of physical examination findings, vital signs, and changes in clinical status as they relate to diagnosis
  • Typical and atypical presentations of surgical conditions
  • Expected postoperative findings and findings suggestive of complications
• Skill in:
  • Formulating appropriately prioritized differential diagnoses
  • Incorporating history, physical examination findings, diagnostic data, procedural findings, and the perioperative course into medical decision-making
  • Distinguishing surgical emergencies from conditions appropriate for urgent, elective, or nonoperative management
  • Recognizing common and life-threatening postoperative complications
  • Recognizing the need for surgical consultation, referral, escalation of care, or additional diagnostic evaluation
  • Selecting the most likely diagnosis in light of the presented data

• Knowledge of:
  • Surgical and clinical procedures and their indications, contraindications, complications, risks, benefits, and techniques
  • Conditions that constitute surgical or medical emergencies
  • Criteria for operative versus nonoperative management
  • Criteria for emergent, urgent, or elective intervention
  • Initial stabilization and treatment of airway compromise, hemorrhage, shock, sepsis, and acute trauma
  • Criteria for admission, discharge, transfer, consultation, and escalation to a higher level of care
  • Preoperative preparation, intraoperative support, postoperative management, and follow-up
  • Management of wounds, drains, tubes, ostomies, vascular access devices, and urinary catheters
  • Fluid, electrolyte, blood-product, nutritional, pain, and venous-thromboembolism management
  • Palliative care, goals-of-care discussions, and end-of-life issues
  • Roles of surgeons, anesthesia professionals, nurses, rehabilitation specialists, pharmacists, dietitians, and other health professionals
  • Sterile technique, universal precautions, infection prevention, and isolation precautions
• Skill in:
  • Recognizing and initiating treatment for life-threatening surgical conditions
  • Prioritizing interventions based on hemodynamic stability, severity of illness, mechanism of injury, and risk of deterioration
  • Formulating and implementing evidence-based preoperative, intraoperative, and postoperative management plans
  • Determining whether operative, nonoperative, or supportive management is appropriate
  • Performing or assisting with appropriate procedures using sterile technique and within the PA’s training and assigned role
  • Administering and monitoring fluid resuscitation, blood products, oxygenation, nutritional support, and other supportive therapies
  • Managing surgical wounds, dressings, drains, tubes, ostomies, vascular access devices, and urinary catheters
  • Evaluating patient response to treatment and intervention
  • Making appropriate disposition, consultation, referral, and follow-up decisions
  • Facilitating patient and caregiver adherence to and active participation in treatment
  • Coordinating care within a multidisciplinary surgical team

• Knowledge of:
  • Indications for use
  • Contraindications and precautions
  • Mechanisms of action
  • Dosing and routes of administration
  • Pharmacokinetics and pharmacodynamics
  • Perioperative management of chronic medications
  • Selection and timing of antimicrobial prophylaxis
  • Pharmacologic treatment of surgical-site, intra-abdominal, urinary, pulmonary, bloodstream, and soft-tissue infections
  • Multimodal management of acute and postoperative pain
  • Prevention and treatment of common perioperative symptoms and complications
  • Pharmacologic prevention and treatment of venous thromboembolism
  • Drug interactions, including presentation and management
  • Presentation and management of adverse effects, allergic reactions, withdrawal syndromes, and toxicities
  • Special populations requiring medication or dose modification
  • Methods to reduce perioperative medication errors
  • Prescribing, monitoring, and regulating opioids and other controlled substances
• Skill in:
  • Performing perioperative medication reconciliation
  • Determining which medications should be continued, withheld, adjusted, bridged, or restarted
  • Assessing patient adherence to therapeutic regimens
  • Selecting appropriate pharmacologic therapy and dosing
  • Prescribing appropriate antimicrobial prophylaxis and treatment
  • Developing and adjusting multimodal pain-management regimens
  • Initiating appropriate pharmacologic venous-thromboembolism prophylaxis
  • Drafting accurate prescriptions and medication orders
  • Monitoring therapeutic response, laboratory values, drug concentrations, and adverse effects
  • Modifying pharmacologic regimens as appropriate
  • Identifying and managing medication-related problems and drug interactions
  • Evaluating, treating, and reporting adverse drug reactions and/or adverse effects
  • Counseling patients and caregivers regarding medication purpose, administration, adverse effects, precautions, and adherence

• Knowledge of:
  • Associations among disease conditions and complications identified through the application of scientific concepts
  • Genetics
  • Surgical anatomy, anatomic relationships, tissue planes, and structures at risk
  • Normal physiology and the physiologic response to surgery, anesthesia, trauma, hemorrhage, infection, and critical illness
  • Pathophysiology of surgical diseases, shock, sepsis, malignancy, and postoperative complications
  • Microbiology of surgical and healthcare-associated infections
  • Immunology and inflammatory responses involved in infection, trauma, transplantation, and wound healing
  • Hemostasis, coagulation, thrombosis, fibrinolysis, and blood-product replacement
  • Phases of wound healing and factors that impair healing
  • Fluid, electrolyte, acid-base, renal, metabolic, and nutritional physiology
  • Pharmacology relevant to anesthesia, analgesia, antimicrobial therapy, anticoagulation, and resuscitation
  • Human behavior, including psychological and social factors that influence surgical decision-making, pain, recovery, adherence, and rehabilitation
  • Public health principles relevant to surgical disease, injury prevention, perioperative care, and population health
• Skill in:
  • Applying surgical anatomy and physiology to patient assessment, procedural planning, and recognition of complications
  • Relating pathophysiologic principles to specific surgical diseases and perioperative complications
  • Interpreting hemodynamic, respiratory, renal, metabolic, coagulation, and inflammatory changes
  • Applying microbiologic and immunologic principles to the prevention and treatment of surgical infections
  • Applying wound-healing principles when evaluating wounds and recognizing impaired healing
  • Applying fluid, electrolyte, acid-base, and nutritional principles to perioperative care
  • Incorporating evidence-based medicine practices
  • Evaluating emerging surgical techniques, technologies, and medical evidence critically as they relate to patient care

Legal/medical ethics

• Knowledge of:
  • Informed consent and refusal for surgical procedures, anesthesia, blood products, and other invasive interventions
  • Decision-making capacity and identification of an appropriate surrogate decision-maker
  • Advance directives, code status, including do-not-resuscitate and do-not-intubate orders, medical power of attorney, organ donation, and goals-of-care decisions
  • Medicolegal and ethical issues related to emergency surgery, operative risk, medical futility, surgical complications, medical errors, and end-of-life care
  • Patient preferences related to culture, religion, gender, blood products, amputation, ostomy creation, and other potentially life-altering interventions
  • Patient rights, responsibilities, privacy, confidentiality, and informed participation in surgical decision-making
  • Effective strategies for navigating legal and policy issues encountered by surgical patients and patient populations
• Skill in:
  • Caring for patients with impaired decision-making capacity and communicating with their legally authorized representatives
  • Supporting informed, voluntary, and patient-centered surgical decisions
  • Providing patient advice and education regarding informed consent and refusal
  • Providing patient counseling related to goals of care and end-of-life decisions
  • Recognizing and escalating ethical concerns to the supervising physician, ethics service, or other appropriate resource

Medical informatics

• Knowledge of:
  • Accurate and complete documentation of preoperative assessments, procedures, postoperative care, complications, and discharge planning
  • Billing and coding requirements for reimbursement, quality reporting, and administrative purposes
  • Clinical decision-support systems, electronic health records, imaging systems, and evidence-based surgical resources
• Skill in:
  • Using appropriate medical informatics sources to support perioperative decision-making
  • Documenting patient status, procedures, clinical reasoning, communication, and transitions of care accurately and promptly
  • Protecting patient information when using electronic communication and health information systems

Patient care and communication (individual patients)

• Knowledge of:
  • Affordable, effective, and patient-specific surgical care
  • Communication and care preferences of diverse patient populations
  • Effects of health literacy, language, disability, culture, social support, transportation, finances, housing, and access to postoperative care
  • Psychological effects of trauma, cancer, disfigurement, amputation, ostomy creation, pain, and prolonged hospitalization
• Skill in:
  • Acknowledging and applying patient and provider rights and responsibilities
  • Establishing rapport and communicating with compassion during stressful or emergent surgical situations
  • Demonstrating cultural humility in patient-based interactions
  • Using interpreters and accessible communication methods when appropriate
  • Explaining diagnoses, procedures, alternatives, risks, expected recovery, and warning signs in understandable language
  • Providing clear wound-care, medication, activity, dietary, device-care, and follow-up instructions
  • Identifying barriers to treatment adherence and coordinating appropriate resources to support recovery

PA role in professional practice

• Knowledge of:
  • Professional and clinical limitations, scope of practice, credentialing, privileging, and supervision or collaboration requirements
  • Responsibilities of the PA during preoperative, intraoperative, postoperative, inpatient, outpatient, and emergency surgical care
  • Roles and responsibilities of surgeons, anesthesia professionals, nurses, consultants, rehabilitation specialists, pharmacists, dietitians, and other members of the interprofessional surgical team
  • Practice parameters, including malpractice, conflicts of interest, impaired clinicians, ethical principles, professional boundaries, and implicit bias
• Skill in:
  • Recognizing personal limitations and seeking assistance or supervision appropriately
  • Communicating and consulting effectively with surgeons, anesthesia professionals, nurses, consultants, and other members of the health care team
  • Participating effectively in operative teams, handoffs, rounds, consultations, and transitions of care
  • Maintaining professional behavior in high-stress and time-sensitive clinical environments

Professional development

• Knowledge of:
  • Continuing medical education resources relevant to surgical and perioperative care
  • Evidence-based guidelines, quality standards, and evolving surgical techniques and technologies
• Skill in:
  • Critically evaluating surgical literature and applying evidence-based medicine
  • Identifying and interpreting information from reliable medical and surgical sources
  • Recognizing personal knowledge or skill gaps and pursuing appropriate education, simulation, feedback, or supervised experience
  • Participating in quality-improvement, morbidity and mortality, and patient-safety activities

Public health (population/society)

• Knowledge of:
  • Disaster preparedness, mass-casualty triage, trauma-system organization, and emergency response
  • Infection-control measures and responses to outbreaks within perioperative and inpatient settings
  • Occupational hazards affecting patients and health care workers, including sharps injuries, bloodborne pathogens, radiation, smoke, and hazardous materials
  • Population health, travel health, epidemiology, injury prevention, and cancer-screening principles relevant to surgical disease
• Skill in:
  • Applying infection-prevention practices and appropriate isolation precautions
  • Participating in disaster response, trauma triage, and allocation of limited resources
  • Identifying vulnerable populations and addressing inequities in access to surgical and postoperative care
  • Counseling patients regarding injury prevention, smoking cessation, obesity, cancer screening, and other modifiable surgical risk factors

Risk management

• Knowledge of:
  • Accountability and standards of care in surgical practice
  • Effective resource management and appropriate utilization of testing, consultations, procedures, medications, blood products, and hospital services
  • Patient-safety measures, including the Universal Protocol in surgical settings, surgical safety checklists, time-outs, operative-site verification, and prevention of retained foreign objects
  • Common causes of perioperative errors, adverse events, communication failures, and preventable complications
  • Mandated-reporting requirements and requirements for reporting safety events, complications, equipment failures, and occupational exposures
• Skill in:
  • Ensuring correct patient, procedure, operative site, consent, allergies, and required equipment before an intervention
  • Using standardized handoffs, medication reconciliation, checklists, and closed-loop communication
  • Recognizing, documenting, reporting, and responding appropriately to adverse events and near misses
  • Preventing wrong-site procedures, medication errors, hospital-acquired infections, falls, pressure injuries, and venous thromboembolism
  • Escalating concerns when patient safety, clinician impairment, equipment function, or standards of care are compromised

Perioperative Settings

*AMBOSS editorial study guidance: The following surgery-specific "Knowledge of" and "Skill in" descriptions were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source.

• Knowledge of:
  • Indications, contraindications, risks, benefits, and alternatives for operative and nonoperative management
  • Components of the preoperative history and physical examination
  • Cardiovascular, pulmonary, thromboembolic, infectious, bleeding, renal, hepatic, nutritional, and anesthesia-related risk
  • Indications for preoperative laboratory studies, imaging, electrocardiography, pregnancy testing, blood-bank testing, and specialist consultation
  • Perioperative management of chronic medications
  • Preoperative fasting requirements and aspiration-risk reduction
  • Antimicrobial and venous-thromboembolism prophylaxis
  • Preoperative fluid, electrolyte, nutritional, blood-product, and bowel-preparation considerations
  • Informed consent, decision-making capacity, advance directives, code status, and refusal of treatment
  • Criteria for emergent, urgent, and elective intervention
  • Required patient, procedure, operative-site, consent, allergy, implant, imaging, equipment, and blood-product verification
• Skill in:
  • Obtaining a focused surgical history and performing a condition-specific preoperative physical examination
  • Identifying findings that require stabilization, additional testing, consultation, postponement, or cancellation
  • Reviewing and interpreting preoperative laboratory studies, imaging, electrocardiograms, and consultation findings
  • Stratifying perioperative risk
  • Reconciling medications and determining which therapies should be continued, withheld, modified, bridged, or restarted
  • Developing a patient-specific preoperative plan
  • Educating patients and caregivers about the procedure, expected recovery, alternatives, risks, restrictions, and warning signs
  • Confirming informed consent and communicating unresolved questions or concerns
  • Completing preoperative documentation, orders, medication reconciliation, and handoff communication
  • Participating in preoperative verification and confirming the availability of required studies, equipment, medications, implants, and blood products

• Knowledge of:
  • Operating-room roles, workflow, communication standards, and team responsibilities
  • Aseptic technique, surgical hand preparation, gowning, gloving, draping, and maintenance of the sterile field
  • Surgical anatomy, tissue planes, structures at risk, and common operative approaches
  • Indications, contraindications, complications, risks, benefits, and basic techniques of common surgical procedures
  • Safe positioning, padding, pressure-injury prevention, and nerve protection
  • Functions and safety considerations of common surgical instruments and operative equipment
  • Principles of exposure, retraction, dissection, hemostasis, irrigation, wound closure, dressing application, and drain placement
  • Recognition of intraoperative hemorrhage, hemodynamic instability, hypoxia, arrhythmia, anaphylaxis, malignant hyperthermia, and other emergencies
  • Fluid resuscitation, blood-product administration, electrolyte management, temperature control, and urine-output monitoring
  • Surgical counts, specimen handling, implant documentation, and prevention of retained foreign objects
  • Universal precautions, sharps safety, radiation protection, surgical-fire prevention, and occupational-exposure management
• Skill in:
  • Participating in the surgical safety checklist, time-out, site verification, and confirmation of antimicrobial prophylaxis
  • Performing surgical hand preparation, gowning, gloving, draping, and sterile technique
  • Positioning and padding patients safely
  • Recognizing contamination and initiating appropriate corrective action
  • Identifying and handling common instruments, sutures, stapling devices, drains, and operative equipment
  • Providing operative exposure through appropriate retraction, suction, irrigation, tissue handling, and assistance with hemostasis
  • Performing or assisting with common operative tasks within the PA’s training and assigned role
  • Monitoring the operative field and patient for complications
  • Communicating changes in patient condition or operative findings using closed-loop communication
  • Labeling and handling surgical specimens accurately
  • Participating in instrument, sponge, and sharps counts
  • Providing an accurate operative handoff

• Knowledge of:
  • Expected physiologic changes and normal recovery after surgery and anesthesia
  • Components of postoperative assessment
  • Postoperative pain management
  • Fluid, electrolyte, glycemic, nutritional, and blood-product management
  • Prevention and treatment of nausea, vomiting, constipation, ileus, urinary retention, delirium, and other common postoperative problems
  • Prevention of pulmonary complications and venous thromboembolism
  • Management of wounds, dressings, drains, chest tubes, nasogastric tubes, ostomies, urinary catheters, and vascular access devices
  • Recognition and initial management of postoperative hemorrhage, shock, infection, sepsis, respiratory compromise, myocardial ischemia, arrhythmia, acute kidney injury, thromboembolism, and neurologic deterioration
  • Recognition of procedure-specific complications, including anastomotic leak, dehiscence, obstruction, abscess, seroma, hematoma, fistula, graft or flap compromise, and compartment syndrome
  • Criteria for advancing diet and activity, removing devices, transitioning medications, discharge, transfer, consultation, and escalation to a higher level of care
  • Rehabilitation, discharge planning, follow-up, wound care, activity restrictions, and return precautions
• Skill in:
  • Performing focused postoperative assessments and comparing findings with the expected course of recovery
  • Reviewing operative and anesthesia records, intake and output, vital-sign trends, laboratory results, imaging, medications, and device output
  • Recognizing clinical deterioration and initiating stabilization, diagnostic evaluation, consultation, or escalation of care
  • Developing and adjusting postoperative management plans
  • Evaluating wounds and managing dressings, drains, tubes, ostomies, catheters, and vascular access devices
  • Monitoring blood loss, drain output, urine output, bowel function, respiratory status, mobility, and oral intake
  • Promoting early ambulation, pulmonary hygiene, pressure-injury prevention, and rehabilitation
  • Identifying and managing common postoperative complications
  • Recognizing life-threatening postoperative complications
  • Determining readiness for diet advancement, device removal, transition to oral medications, discharge, transfer, or higher-acuity care
  • Providing clear discharge and return-precaution instructions
  • Completing postoperative documentation, discharge summaries, prescriptions, follow-up arrangements, and transitions-of-care communication

AMBOSS is an independent entity with no affiliation to or endorsement by the PA Education Association (PAEA) or the PAEA End of Rotation™ examinations. The PAEA-derived portions of this article are based on the publicly available PAEA Surgery End of Rotation™ Exam Blueprint, Topic List, and Core Tasks and Objectives, which are solely created and owned by PAEA®. The surgery-specific "Knowledge of" and "Skill in" descriptions, perioperative study guidance, and organization of certain Professional Practice concepts were developed by AMBOSS and are not taken verbatim from the PAEA Core Tasks and Learning Objectives or from another source. AMBOSS does not claim ownership of material originating from PAEA. This article is provided at no cost to the public as an informational resource for PA students, educators, clinicians, and other healthcare professionals. It is not an official PAEA publication and does not contain actual PAEA examination questions. Questions on an examination represent only a sample of the content that may be assessed, and the Topic List is not a comprehensive list of all possible examination topics. Use or reproduction of PAEA materials is subject to PAEA’s applicable terms and any required permissions. ^[2]