I Can Count On You
True or False: 4x4 gauze is acceptable to use in the abdomen as a surgical sponge.
What is false?
What is the guideline for perioperative hair removal?
What is leaving hair in place at a proposed surgical site whenever possible?
In the State of NH, it is not in the scope of practice for a ___________ to mark the surgical site.
What is a nurse (without APRN licensure)?
Your patient's surgical procedure is complete and you are ready to transfer them to the ICU. You notice there are 400ml of autologous blood to return to the patient from the cell saver that has not been started yet. What two steps can you take next?
What is start the transfusion prior to transfer or discard the autologous blood?
Per policy, medication allergies should be verified by _______________.
Who is the nurse?
***All team members should review as part of the time-out process***
How should two team members count surgical sponges?
What is by separating the sponges completely.
Hair removal in the OR must be followed by ______.
What is sticky mitt (tape) or suction?
The SDC (preop) nurse completed the pre-procedure checklist. How should the OR (circulating) nurse proceed with their pre-op assessment?
What is repeat the pre-procedure checklist and document in the EMR if not previously documented?
Name two absolute contraindications for using intraoperative blood salvage.
What is: hypotonic solutions, hemostatic products (thrombin, microfibrillar collagen agents), bone cement, or toxic solution for intravascular administration (alcohol, povidone-iodine, bacitracin)?
What information should the ST or RN Scrub be writing on the medication label on the sterile field?
What is name and strength of medication?
If you have multiple procedures or sterile fields, what items need to be counted at the final count.
What is all items?
________ and _______ will collaborate and determine whether a procedure should be preformed with jewelry in place on a patient.
Who are the surgeon and anesthesia provider?
The universal mark for signifying surgical site and laterality is _________?
What is initials?
In the event 4% sodium citrate is unavailable, a solution of ______________ may be used.
What is 30,000 units heparin in 1 Liter of NaCl?
All medication vials will remain in the OR until _____________________.
What is the patient is out of the room?
The ST is deferring to complete a closing instrument count after preforming a pediatric inguinal hernia repair on a 6 month old patient. How should the RN Circulator respond according to Elliot policy.
What is per policy: closing counts may be deferred when the wound is such that no instrument could inadvertently be retained?
Where can education for surgical patients regarding jewelry in the operating room be found?
What is attached to the "patient jewelry in the operating room" policy?
What is the guideline for site marking on procedures involving bilateral structures?
What is: the site does not need to be marked for bilateral structures (i.e. tonsils, ovaries)?
Name the three relative contraindications (decision for use will be made by the surgeon) for intraoperative blood salvage.
What is sepsis, contamination with bowel contents, and active malignancy?
______________ is an extended release anesthetic medication. Additional doses cannot be given within _________.
What is exparel?
What is 96 hours?
A patient is about to leave the OR with radiopaque sponges intentionally left in the wound. The OR team does not know how many sponges are in the wound. Does this situation require a intra-op x-ray?
What is no?
What are the two steps a nurse must complete when a patient declines to remove jewelry prior to surgery?
What is provide education to the patient and document?
A Trauma Alpha is called for a patient involved in a MVA and suffered complete amputation of their left arm. Is it acceptable to bring this patient to surgery without site marking for surgical completion of left arm amputation?
What is yes?
"Site marking is not required for obvious wounds or lesions unless there are multiple wounds or lesions."
The documentation of blood transfusion and the use of the cell saver can be found _____________ and ____________.
What is in the anesthesia record and "Cell Saver Log Book?"
When compounding medications in the OR, reconstituting or mixing of medications should occur when?
What is a close as possible to time of use?
(should start administration within 1 hour of compounding)