TCB
These 2 personnel are responsible for performing all necessary counts.
Circulator and scrub person!
This is the original configuration of laps and raytecs.
5s and 10s
All countable sponges used should have this feature.
Radiopaque element
Any incision longer than this must have an instrument count.
>1 inch
This is done prior to the beginning of a procedure to establish a baseline.
Initial count
This is used to maintain counts throughout the procedure.
Count board
This many counts should be done at a minimum.
What is THREE (baseline, closure, end of procedure)?
This should be done if counts are incorrect and unable to be reconciled.
X-ray
This part of the initial count is required, even for laparoscopic/robotic cases.
Instrument count
These are to be utilized to contain used sponges when counting and should be filled from the bottom up.
Count bag
All items should be counted this way so everyone involved can hear.
Audibly
All instrument sets must come with this item.
Count sheet
Cases using this must perform AT LEAST sharp/sponge counts.
C-arm/fluoroscopy
Suture boots, vessel loops, hypo needles, and cottonoids are all examples of this.
Miscellaneous items
This position requires an additional count after the patient is returned to supine.
Lithotomy
This person can request a count.
Anyone!
Counting on the field is performed in this order.
Operative site, mayo, back table, surrounding area
An x-ray will be performed in this type of case that initial counts were unable to be completed.
Emergency case
These items should be announced and documented when they are placed and removed during a procedure.
Packing (throat, abdominal, vaginal)
An additional count is done when this hollow/open area is closed.
Organ/cavity/retroperitoneal space
This is the sequence for counts and should be performed every time.
Sponges, sharps, miscellaneous items, instruments
This will be completed for any incorrect count.
Occurrence report
This person renders a final interpretation of an x-ray for a count discrepancy.
Radiologist
This size needle may not be detectable on x-ray.
10mm or smaller
Sponges counted and used during the procedure will not be utilized for this postop purpose.
Dressings or intentional packing