Personnel
The circulator and the surgical tech.
Who are the two people who should conduct counts?
The person who has responsibility to ensure that the circulator sees each surgical item being counted.
Who is the surgical tech?
Radiopaque items, and never non-radiopaque items.
What are soft goods that can be used in the surgical field?
If a count discrepancy occurs, this needs to be entered?
What is an SEMS report?
Suture needles, hypo needles, sponges, vessel loops, blades, bovie tips, peanut sponges AND ANYTHING ELSE USED IN THE SURGICAL FIELD THAT COULD REASONABLY GET LEFT BEHIND.
What are the items included in a count?
Any individual who observes an item dropped from the surgical field will immediately do this.
What is inform the circulator and other team members?
Counted audibly and view concurrently by two individuals, one of whom is the circulator.
What is how counts will be conducted?
Items removed from the field, bagged, labeled, isolated, and excluded from the count.
What are packages containing an incorrect number of sponges or a manufacturing defect?
If a counts discrepancy occurs, this must be documented in the patient record.
What are actions taken to resolve, and the outcome of those actions?
Before the procedure, when new countable items are added to the field, before the closure of a cavity within a cavity, beginning of wound closure, at skin closure, and at the time of relief of either the scrub person or circulator.
What are the times when counts are done?
If a counts discrepancy occurs, this person instructs the circulator to call xray.
Who is the surgeon?
An assistive count device that hangs on an IV pole that should be used on all procedures.
What are pocketed sponge bags?
Items withheld from the field until the final count is conducted.
What are non-radiopaque sponges used for skin dressings/prep?
Cystos, closed reductions, and some of the other kinds of procedures with no incision.
What are cases that don't require any counts?
Times when sponges may be cut or altered in any way.
What is never?
If a counts discrepancy occurs, this person must be the one who reads the films before final closure of the wound.
(Who is a radiologist?)
On the counts board.
Where is the appropriate place to document counts, so that all team members can readily see it at all times?
Times when an instrument count needs to happen on a laparoscopic case.
What is at the start of the procedure always, and before cavity closure if the case opened?
The number of counts required on a total joint procedure.
What is 3?
Preprinted count sheets.
What are used to record counted instruments?
A non-sterile personnel can perform initial counts, document on count board, and communicate to primary RN
Who is a second circulator or RNFA
When counts can be waived.
What is when they are likely to be unachievable or when time required may present an unacceptable delay?
Individual pieces of assembled instruments are accounted for in this way such as a non-disposable pool suction
What is separately?
Xray is not needed for lost needled smaller than
10mm
What the scrub person does if a broken or separate item is returned from the operative site.
What is immediately notify the perioperative team, and account for all parts of the item?