When surgical tools get left behind

[lockheart678]

I just caught these two shows on the Discovery fit and health channel over the weekend. I thought they were interesting, but I was left screaming at the tv during most of it. They put so much emphasis on counting errors, yet when they showed the person who was scrubbed in counting instruments, the person never separated the clamps! For a show like that, the least they can do is count properly!

It is really amazing to hear about some of the things that have been accidentally left in patients. The shows featured two different patients that discovered they each had 2" malleables left in, and another patient had some kind of 9" clamp! I can understand how a surgeon can glance in the belly and miss a saturated lap or raytec because they blend in so well, but huge instruments like that? Clearly, the OR staff did a terrible job counting in those cases, but how can a surgeon be so negligent to miss a huge malleable!

Since I know how the OR works, I think there are quite a few things these shows could have improved on to be more true to reality, but I guess they figure the general public would never understand, so they would never know the difference. Has anyone else caught these shows before?

[Poochiewoochie]

I'm not a nurse but I saw them. IMO most of the "true life" medical shows tend to be a tad bit over exaggerated. Television is all about ratings and these medical shows tend to try to scare the general public.

[CaliLvr000, BSN, RN]

My first hospital I worked at/learned OR nursing, almost got shut down. General surgeon left in a huge blue fish :-\ (he closed so fast and would not wait for counts). Around the same time they removed 3 sponges from another pts abdomen (different surgeon) that had been giving them pain for YEARS. I work at a much better hospital now where surgeons actually care about counts.

[Rose_Queen, BSN, MSN, RN]

Sensationalism gets viewers. That's really all they care about. Same thing with all the medical/cop/whatever shows- reality wouldn't attract viewers.

[Poochiewoochie]

Sensationalism gets viewers. That's really all they care about. Same thing with all the medical/cop/whatever shows- reality wouldn't attract viewers.

Yeah, none of the so-called reality shows are actually reality. What gets me is when someone is shocked to find out that their favorite one is staged.

[lockheart678]

My first hospital I worked at/learned OR nursing, almost got shut down. General surgeon left in a huge blue fish :-\ (he closed so fast and would not wait for counts). Around the same time they removed 3 sponges from another pts abdomen (different surgeon) that had been giving them pain for YEARS. I work at a much better hospital now where surgeons actually care about counts.

Wow, that's crazy. I don't understand how he couldn't remember to pull it out when clearly he used it for a reason. That's scary that he didn't care about the counts, but I've worked with surgeons like that. You tell them something is missing and they automatically assume it's the staff's fault for counting wrong. It couldn't possibly be in the abdomen, even when they had to open it emergently due to the artery they just hit (I only wish I was making this up) trying to perform a laparoscopic procedure.

[sop832]

If I had a nickel for every time I have heard "Well, it's not in here" when I tell a surgeon that we are looking for a lap, raytex, needle or instrument, i would be driving a better car!

[Mulan]

I thought it was really interesting that the doctor that left the clamp in the guy initially was just going to leave it in.

What's a blue fish?

[Rose_Queen, BSN, MSN, RN]

What's a blue fish?

A flexible piece of plastic that surgeons use to hold the bowel inside the abdomen while they're closing it. When they're almost finished, it can be pulled out through just a tiny bit of the incision before they throw the last few sutures. The ones we use are disposable and have a ring attached that is supposed to stay outside the abdominal cavity to pull it out by and to serve as a visual reminder that it's still in.

[gcruzRN]

I think it depends on what facility you work at. Where I worked before, it was very strict. Everything had to be counted and needs to be separated and the surgeons always want to make sure if the count is correct. And where I worked at we always had 2 circulators and these circulators made sure that everything is accounted for and that surgeons do not rush the closing part. I think such problems (having instruments getting left behind inside the pts body) is due to surgeons rushing ahead and get the next pt in the OR and the circulator is too scared to say something about it.

[SandraCVRN]

The problem with things like malleables, is that many times they are still "up" when they are counted. Many times when surgeons close there is a malleable, open lap, or fish "in" until the last few sutures are in. With the lap or fish the tag should be outside the pt, also the end of the malleable should also be sticking out.

We know where everything is, but making sure that LAST item is out seems to be the problem. I am parenoid until I see that last lap come out. The heart guys I work with will always stop if we say hold up for the count. What ticks me off is when someone knows they dropped something during the case and never say anything even after you are hunting.