Sponge Count for Vag Deliveries

Specialties Ob/Gyn

Published

I'm interested to know how many nurses are doing sponge counts for lady partsl deliveries...

and...

1) what your SOP for this is based on

2) do you use radiographic sponges exclusively now so that if your count's off & you have to do an Xray something will show up?

We are going to be implementing this at our facility - personally, I think it's ridiculous.

Thanks,

KC :(

I was sorta joking - we don't use sponges. Blue sterile towels.

If someone is hemorrhaging, we do have those big old lap sponges used back in surgery but you'd be hardpressed to lose one of those.

Hardly ever happens though.

steph

Oooohhh. :smackingf :lol_hitti

Yeah, we generally just use blue sterile towels and lap sponges. We have to open the Raytex if they want it.

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Oooohhh. :smackingf :lol_hitti

Yeah, we generally just use blue sterile towels and lap sponges. We have to open the Raytex if they want it.

Oh please stop hitting yourself in the head! :) It is so very easy to not communicate well online.

steph

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I'm interested to know how many nurses are doing sponge counts for lady partsl deliveries...

and...

1) what your SOP for this is based on

2) do you use radiographic sponges exclusively now so that if your count's off & you have to do an Xray something will show up?

We are going to be implementing this at our facility - personally, I think it's ridiculous.

Thanks,

KC :(

Our docs and CNM's have to count their own sponges and sharps before leaving the room. We only have one doc who refuses to do it, but I ahve no problem calling her back in or wriiting her up if there is something missing.

Remember, a surgeon cannot leave the OR is a count is off. Should be the same in a vag delivery. If the doc is a pain about it, give him/her a place to put all the sponges (like on the corner of your delivery table) and you can see them easily when all is done. Helping the doc in that way and working together is uaully a way around that.

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YES... we do count sponges and YES we use raytec.... 20 of them in fact... to prep with and for docs to use during repair (sometimes they pack the lady parts to stop blood flow during repair).

Just a story...

A few weeks ago I came on shift and took over the recovery of a recent delivery. I got report that the sponge count was off by 4. But that the doc (a resident) was sure that no sponges were left inside and did not want an x-ray. I reviewed chart, hx (pt hep B +) and went in to check in on the pt. 15 min earlier it was recorded that "small, firm, @ U). I found the pt laying in a puddle... gushing... bogey. Fudus would not firm up despite vigorous massage and pit bolus. I did a (high) lady partsl sweep... dug out all the clots I could reach and called and got an order for methergine. Ended up being over 1200cc blood loss (by weight). Well, you can guess it... on a hunch I dug through all the clots I fished out and yep... there were the 4 sponges.

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YES... we do count sponges and YES we use raytec.... 20 of them in fact... to prep with and for docs to use during repair (sometimes they pack the lady parts to stop blood flow during repair).

Just a story...

A few weeks ago I came on shift and took over the recovery of a recent delivery. I got report that the sponge count was off by 4. But that the doc (a resident) was sure that no sponges were left inside and did not want an x-ray. I reviewed chart, hx (pt hep B +) and went in to check in on the pt. 15 min earlier it was recorded that "small, firm, @ U). I found the pt laying in a puddle... gushing... bogey. Fudus would not firm up despite vigorous massage and pit bolus. I did a (high) lady partsl sweep... dug out all the clots I could reach and called and got an order for methergine. Ended up being over 1200cc blood loss (by weight). Well, you can guess it... on a hunch I dug through all the clots I fished out and yep... there were the 4 sponges.

I hope you took this up with the resident as well as the attending!!

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I hope you took this up with the resident as well as the attending!!

Oh yes... as well as a filed incident report on the occurance!

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Specializes in OB, Telephone Triage, Chart Review/Code.

Back in the 80's after I delivered lady partslly, I could not pee. The nurse kept coming in every hour wagging a catheter. Finally, I went in to the bathroom because the pressure was so great, I took a couple of deep breaths and closed my eyes, relaxed my perineum and heard a plop in the toilet. Called my nurse on the emergency light and you guessed it...a sponge. The nurse seemed nonchalant about it.

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Thank you everyone for posting your replies on the sponge count in vag. deliveries thing.

I've been an OB nurse since 1985 & have never done this; have not (thankfully) seen any patients with retained lady partsl sponges, either (in any of the 11 facilities I've worked in). Although many of you responded that you've seen this happen, I think that overall in the U.S. it's quite an infrequent happening. I've only even found one study on this, which stated that 11% of cases involved lady partsl sponges being left in (out of how many overall cases I don't know, or over what period of time). Also, I haven't seen many OB's, midwives, or FP's put sponges way up into the lady parts during repairs. Most of the time it's just not necessary.

I still think this is not something I want to do, but it's coming anyway. So now we will have to make sure that all sponges have something radiopaque on them & come up with who's doing the counts & take the time to do it. Sheeeeeeesh!!! Getting time for me to retire in a few years, thank Goddess!

Anyway, a big thanks again to all of you who responded.

KEC in Pensacola :o

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