TOOLS OF THE TRADE
POINTS OF INTEREST
MIA
TALLY HO
MIXED REVIEWS
100
This should be used instead of laps, towels or malleable retractors when closing the abdominal cavity.
What is visceral retainer. (fish)
100
When a needle or suture pack is opened onto the sterile field, the scrub and circulator must do this.
What is verify the number of needles.
100
Linen and this must remain in OR from initial count until after the final count has been reported as correct.
What is trash. All counted items must be removed at end of each procedure.
100
When you are doing radiofrequency scanning this is still required.
What is a count. RF scanning is an adjunct to counting and does not replace the manual counting process.
100
All counts are done by these team members.
Who are the circulator and scrub (at least 1 must be RN)
200
Instruments will be counted at initial count when this is or could be entered.
What is body cavity.
200
Sharps to be included in counts. (Name 3)
What are: cautery tips, knife blades, hypodermic needles, suture needles, other items as determined by team. ie: scoville needles
200
This must be done if have incorrect count or an "unintentionally" retained counted item is removed.
What is a PSN.
200
What the scrub person does to the sponge packet when counting with the circulator.
What is break the band and separate sponges while counting so that both the team members can see items.
200
This must be done daily prior to RF mat/wand use.
What is initial scan.
300
A limited instrument count would include these items. (name 3)
What are: temporary aneurysm clips, bulldogs, potts bulldogs, fistula tips, coronary artery occluders, femoral head trials, S & T vascular clamps, titus needles, varus needles, yassergils.
300
What should not be used to verify the needle count?
What is: Suture packs
300
In the event of incorrect count, these people need to be notified.
Who are: staff surgeon, charge nurse, radiology for x-ray to rule out retained foreign body.
300
When using a throat pack this must be done.
What is activate the "throat pack in" sign on the door. This stays until the throat pack is removed.
300
Counts are performed at these times.
1 prior to beginning of procedure 2 closure of any cavity 3 initial wound closure 4 start of skin closure 5 permanent relief of either scrub or circulator 6 when any surgical team member feels the need for a count
400
This should be inspected and/or counted when instruments have removable pieces.
What is yankeur suction tips, screws on instruments, blades on self-retainers.
400
An x-ray should be taken for missing suture needle larger than this.
What is 17mm.
400
An incorrect count is resolved only after this happens.
What is two consecutive correct counts of counted item type.
400
These should be included on the appropriate count worksheet/card.
What are the patient name and MRN. (zebra label)
400
This must be done when skin closure complete.
What is RF scan (either mat or wand). When wanding make sure to do vertical & horizontal scan. Remember to chart confirmation code in epic.
500
Procedures requiring a full instrument count to be done at closure.
What is any surgery into chest or abdomen with incision greater than 3".
500
This needs to be done prior to sealing the red sharps box when it becomes full.
What is: count items by 2 staff members, seal and remove from sterile field; circulator label with items & numbers, remove from count sheet.
500
Documentation of sponges intentionally left in a wound is done here.
Where is EMR (Epic), noted in count comments and nursing notes. (remember log #)
500
When a sponge count bag is used this must be done.
What is place one sponge in each compartment for visualization during the count. Bagged sponges must be verified by 2 staff members (1 must be RN) prior to removing from count sheet. Throwing items off sterile field should be done in original package numbers. ie: laps 5, raytec 10
500
Defined as the time at which the patient is discharged from the OR or the time at which the patient is extubated, which ever occurs first.
What is surgery end time or After surgery.
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