Surgical Count

Question 1

What is the purpose of the surgical count?

Answer 1

Pt and personnel safety
Infection ctrl
Prevent death
Inventory purposes
Avoid lawsuit

Question 2

What sequence should the surgical instruments be counted?

Answer 2

Sponges
Sharps
Extras (misc)
Instruments

Question 3

When does a full count need to be done?

Answer 3

For major cases involving entering cavities such as :
Peritoneal
Pelvic
Retro peritoneal
Thoracic cavities

Question 4

When are surgical counts done?

Answer 4

Prior to start of sx
First layer of closure depending on cavity entered.
Skin closure- instruments do not require recounting
Time of relief of circulating or scrub nurse

Question 5

When are additional counts required?

Answer 5

Additional Sponges, sharps and suture reels done prior to closure of cavity within cavity e.g uterus in c section

Question 6

Items should not be placed on _______ until completion of initial count.

Answer 6

Mayo table

Question 7

If there is an interruption during the count where will it resume?

Answer 7

At end of last item recorded.

Question 8

What do you do for additionally added items?

Answer 8

Immediately counted, recorded and initialed on count sheet

Question 9

What is the recommended sequence for counting at closure (tables)

Answer 9

Field count (incision area)
Table count (mayo and back table)
Floor count (items off sterile field)

Question 10

What happens to the count in an emergency?

Answer 10

May not have time so scrUb nurse tried to keep account of items
Notify supervisor
Arrange for X-ray at end of procedure
Complete incident report
Document on OR record

Question 11

What should you do if the count is incorrect?

Answer 11

Notify surgeon immediately
Re-count
All attempts made to find missing item
Surgeon searches wound and surgical field
Notify supervisor
Order X-ray of pt in theatre
Document the results
Record incorrect count and sign sheet
Incident report

Question 12

How are sponges counted?

Answer 12

Separate types are counted separately
Should be radiopaque and this must be seen by both C and S
Counted twice so packaged groups of 5 or 10
Radiopaque ties should be pull tested.

Question 13

What happens if package has incorrect number of sponges?

Answer 13

Put in bag and removed from theatre.

Question 14

When are radiopaque sponges not used?

Answer 14

For dressings

Question 15

Dressing material should not be added to sterile field until when?

Answer 15

Final count complete

Question 16

If non radiopaque sponges are used for prep when should they be discarded?

Answer 16

Before incision

Question 17

What do you do for towels and sponges used for packing?

Answer 17

Notify circulator
Should be radiopaque
Counted and documented to prevent incorrect count
Type should also be recorded
PACU should be notified how many and what kind

Question 18

How should packing that is removed be handled?

Answer 18

Document type and number

It is confined, contained, labeled and segregated from other sponges in theatre.

Question 19

What if packing is permanently removed a s no other packing is necessary?

Answer 19

Pt should be X-rayed before leaving theatre.

Question 20

Needles are given on an ____________ basis.

Answer 20

Exchange

Need to get one back before you give another

Question 21

Multipack needles should be opened and counted at _________ count.

Answer 21

Initial

Question 22

When do we not have to count?

Answer 22

Life or death emergency
When not entering skin
Minor procedures (myringotomies, cysto)