Surgical Counts
How many counts should be performed during a surgical procedure?
Three
(initial, closing, final)
How long is the H&P valid for?
30 days
What medication documentation should be included in the chart?
medication name, dose, route, time, and person administering
What is crucial with patient transfers?
Clear communication between staff
What is the purpose of the x-ray badges that live in the back hallway?
In which order does the scrub count in?
Sterile Field --> Mayo stand --> Back table --> items off the sterile field.
New information rises or plans change for a procedure. What must be done?
Obtain a new surgical consent
During the debriefing, what words/things should be removed from the procedure that was performed?
"possible", abbreviations, things not performed
How many people should be involved in transferring a patient from OR table to stretcher/bed?
minimum 4
How should x-ray gowns be stored?
Flat or hung up
What cases require instruments to be counted?
Open Cavity/Belly & Laparoscopic
Who is allowed to mark the laterality on a patient?
Surgeon or PA if they are part of the procedural team
What must be done with a specimen before surgeon leaves the room?
Verification of specimen (including type and source).
How should arms be position on arm boards properly?
Padded and 90 degrees or less
What is the ideal distance you should remain away from the x-ray machine?
6ft
What are the 3 critical times to perform a count?
Before the procedure. Before cavity closure. Before skin closure/end of procedure.
Where should you see a site marking at for laterality specific cases?
At/near the surgical site that is visible after being prepped and draped.
How long does it take for a patient to experience nerve injury when they are in the same position?
2-4 hours
Where should your x-ray badge be placed?
side of the body that is closest to the c-arm or on the center of the thyroid shield.
What happens when you have a discrepancy in your count?
Notify the surgeon to stop closing and search for the missing item.
The surgical consent contains procedure name, provider name, and what other two key elements?
Risk and benefits
What are the 3 critical elements of the surgical time out?
correct patient, correct procedure, and correct site
What should be included in the intra-op charting regarding positioning?
Equipment/positioning aids used. Skin/pressure assessment.
What part of the c-arm puts off the most radiation?
The image intensifier
(the part closest/attached to the base)