Sponges
Sharps
Miscellaneous Items
Fun Facts
Now What
100
Baseline count done prior to skin incision and time out
What is an initial count
100
the smallest mm that is not needed to be counted.
What is 15mm If a needle <15mm is missing in a large cavity case, after a thorough search of the wound and sterile field an x-ray is not required. The final count for sharps and needles will be recorded as incorrect. A Confidential Occurrence Report will be filled out.
100
Performs the surgical count procedure concurrently with the scrub nurse and documents accurately.
What is the circulating nurse
100
Sequence of closing count _____, ______, & _______
What is bucket, sterile field, mayo stand?
100
The circulating nurse informs the surgeon of a missing item. The surgeon stops closing. A visual inspection of the surgical field is performed by the scrub nurse, all linen and garbage bags are searched by the circulating nurse. If item not found, x-ray is taken.
What is reconciling a count?
200
Is considered a dressing and just like other dressings it is not to be included with the surgical sponges.
What is a Vaginal Pack
200
Are always placed in a neutral zone, usually on mayo stand.
What is sharps?
200
Is NOT an instance of reportable retained sponge, but needs to be charted on the patient's operative record.
What is Therapeutic Packing? When surgical sponges are intentionally left for intra-cavitary packing, and the patient leaves the OR. Packing will be removed at a later date.
200
An instance when 2 separate counts are needed for the same patient.
What is during a surgery that has multiple surgeons, more than one incision, and different set-ups. Exception: CABG
200
Form to be filled out if there is an incorrect count, or if during an emergency situation an initial count is not done.
What is Confidential Occurrence Report?
300
Counts that are done at the closure of a cavity and skin.
What is a Closing Count? Only need 1 closing count if peritoneum has not been entered, or if the incision is smaller than instruments. Port sites do not require 2 closing counts.
300
are metallic, pointed or cutting objects of various sizes which include but are not limited to: suture needles, scalpel blades, hypodermic needles, cautery tips.
What are Sharps?
300
All items must be _____ & _____ by both counting parties
What is visualized and audible
300
This person is responsible for the management of items.
What is the scrub nurse Everyone involved in the surgery is ultimately responsible for proper management of all surgical items.
300
The time when a full instrument count is needed.
What is during closure of a cavity, cavity within a cavity (ie. uterus) or at permanent staff relief (change over)
400
A pack of sponges does not have the advertised amount, or any surgical device is found to be defective.
What is remove item from sterile field and isolate? Take the item and packaging out of the theatre, and inform ERT of the lot number for proper follow-up can occur with the manufacturer.
400
A process involving two people whereby they look at the items together, one person manually separates each item and they audibly count the number of items (“see, separate and say”).
What is a Surgical Count
400
Can only be recorded as CORRECT or INCORRECT
What is the Final Count
400
An item that was not intended to remain in the patient, is found in any part of the patient’s body, after the operation, vaginal birth or procedure ends.
What is a Retained Surgical Item
400
Is responsible for medical record documentation
What is a nurse Counts and other required information should be entered concurrently with an occurrence or at the end of the case. Documentation in the medical record serves as legal evidence of what practices were performed.
500
Portion of sponge that is seen on x-ray. Sponges should never be cut or altered.
What is radiopaque?
500
Time when the circulating nurse announces the result of the count
What is after the first, and final count. Also mentioned during debriefing.
500
Objects used during surgical procedures that are often single use, often not radiopaque, may be plastic, may be composed of multiple parts and may include but are not limited to: bovie scratch pads, vessel loops, rubber shods, suture booties, umbilical tapes, laparoscopic trocars, disposable instrument inserts, cotton-tip applicators, marking pens, suture reels, screws, nails, safety pins, ligaclip bars, bulldogs, vascular inserts, nuts and bolts. This category also includes device fragments and separable parts of surgical tools (e.g. drill bits) which may become retained.
What are Miscellaneous Items
500
surgical tools designed to perform a specific function such as cutting, dissecting, grasping, holding, suturing or retracting. These items are usually stored and sterilized on surgical trays and individually may have multiple parts.
What are instruments? All portions of instruments must be accounted for.
500
When a vaginal vault count is needed
What is during a vaginal hysterectomy
M
e
n
u