counting cottonoids neuro cases

stevierae · Sep 2, 2004

question.....did a case today and a cottonoid was left in the back we did recover it but not after a lot of searching and an X-ray we had to re explore the wound and low and behold the suspicious mark on the x-ray was the pattie.....do your scrubs hand off the patties or do you just watch as they are counted???? I usually have the scrub fill the card and hand them off to me....first time in 20 years this happened

I have them either throw them off as they are used, and I tie them in groups of 10, and we count them together, as the scrub has time to look, or I do as you do and have them fill the card and throw off the complete card--which we STILL count together when the scrub can do so.

Once they start closing the dura, (on cranis) I have them throw ALL the cottonoids off the mayo and back table--at which point I will tie THOSE in groups of 10 and we will count them together.

Some places count cottonoids by size--that is, 1/2 by 1/2s, 1 by 3s, etc. are all counted and added to the board in the section reserved for them. Some count cottonoids all together. I think it really does not matter, as long as you come up with the correct number of cottonoids when you count. If you do them separately, according to size, and one is missing, at least you know what size you are looking for if you have to go through the trash or linen.

You can always simply opt to get an X-ray and not waste time going through the trash or linen--if it's not in the brain, (or back) it's not in the brain or back, and that's all you care about. However most people, for their own peace of mind, feel better if they know WHERE it is. Sometimes that's impossible--on a bloody aneurysm or tumor in which they've used 250 cottonoids, it may well be on the bottom of someone's SHOE--someone who LEFT 3 hours before it was discovered missing. What you want to determine is whether it's in the patient's body--if X-ray shows it is not, then the rest is a non-issue.

angel03 · Sep 2, 2004

I have them either throw them off as they are used, and I tie them in groups of 10, and we count them together, as the scrub has time to look, or I do as you do and have them fill the card and throw off the complete card--which we STILL count together when the scrub can do so.
Once they start closing the dura, (on cranis) I have them throw ALL the cottonoids off the mayo and back table--at which point I will tie THOSE in groups of 10 and we will count them together.
Some places count cottonoids by size--that is, 1/2 by 1/2s, 1 by 3s, etc. are all counted and added to the board in the section reserved for them. Some count cottonoids all together. I think it really does not matter, as long as you come up with the correct number of cottonoids when you count. If you do them separately, according to size, and one is missing, at least you know what size you are looking for if you have to go through the trash or linen.
You can always simply opt to get an X-ray and not waste time going through the trash or linen--if it's not in the brain, (or back) it's not in the brain or back, and that's all you care about. However most people, for their own peace of mind, feel better if they know WHERE it is. Sometimes that's impossible--on a bloody aneurysm or tumor in which they've used 250 cottonoids, it may well be on the bottom of someone's SHOE--someone who LEFT 3 hours before it was discovered missing. What you want to determine is whether it's in the patient's body--if X-ray shows it is not, then the rest is a non-issue.

Hey thanks just wanted to know what others did...and I also count with my scrub after the filled card is passed off.........you are correct it does not matter where it is as long as it is not in the body...but being compulsive as we all are in the OR we all have to know we searched everything....thanks for the imput stevierae

SuperSGirl · Oct 9, 2004

I worked in the O.R. for 10 1/2 years. As a circulator, you must see every thing that is counted whether it is on or off the field. Counting should start at the wound site, to the mayo, to the back table, to off the field. As the RN, you are ultimately responsible for the count. I always had the scrubs hand the used cottonoids off of the field. An introperative x-ray should have been taken before wound closure.

angel03 · Oct 9, 2004

I worked in the O.R. for 10 1/2 years. As a circulator, you must see every thing that is counted whether it is on or off the field. Counting should start at the wound site, to the mayo, to the back table, to off the field. As the RN, you are ultimately responsible for the count. I always had the scrubs hand the used cottonoids off of the field. An introperative x-ray should have been taken before wound closure.

I agree with you.....an x-ray should always be taken before the wound is closed.....

.....this has been addressed by our mananger......by the way a supervisor in the room when the surgeon insisted on closing.......hard lesson learned by all.....including the surgeon...thanks for your imput....