Where do you put your used sponges? L&D RN in NJ

NurseEllie · Mar 10, 2006

Where I work, the sponges are dropped into a non-sterile basin by the scrub. When they start to accumulate, the circulator straightens them out so the scrub can see the individual sponges in groups of 5 (Laps) or 10 (raytec). The circ. counts once by herself, then once with the scrub. Afterwards the circ. places them in an ordinary clear plastic bag and marks them off the count sheet. If a count is incorrect, we open up the bags to make sure they weren't mis-counted. Its not very fancy, but it works.

JLynnOR · Mar 12, 2006

My first OR, in a small community hospital, used the hanging sponge counter bags. This is what I came to expect as the standard.

I then got a job working within a large health system in a moderate-sized city. My OR used a kick bucket and people would hold the laps up by the strings, around each finger and then wrap the ball of 5 in a wrapper or enfold them all in the exam glove (peeled off carefully). The Ray-tecs would be carefully laid over the edges of the kickbucket and counted that way.

The glove thing I personally found disgusting. There was a good chance that you'd end up with blood on your hand. And, if you ever had to question whether there had accidentally been a ray-tec stuck on a lap sponge, getting them out of an inside-out glove was also disgusting.

At my new hospital within the same lg. system, we bought the hanging bags. It is MUCH safer, in my opinion, clearly displays them in the eye-shot of scrub, surgeon and anesthesia provider, less messy, etc. And, after all, it is 2006. In the age of neurotic med/fluid labeling, meticulous flash-sterilization logs, and other safety initiatives, anything less does seem a little crude.

OR male nurse · Mar 13, 2006

We lay out a 1/2 sheet on the floor and the ST tosses the laps or raytex onto the sheet. When the RN has time, they lay them out in rows of 4 with the 5th sponge underneath for a count of 5. When there are several rows, you ask the ST to verify 5 laps or 10 raytex and then they are bagged into clear plastic bags and set to the side of the 1/2 sheet. It's quick and easy with no hanging bloody sponges or piles of sponges in a bucket to have to pick up, seperate and count later. You can look down at the 1/2 sheet at any time and take a visual count of your sponges and plastic bags and know how many you have. Not saying this is the perfect or best way, just the simple way we do it where I work.

BoTnut · Mar 14, 2006

With some of the responses I am wondering how big your OR rooms are and what type of surgery you do? I am picturing our OR room when it is packed with equipment, people and the patient (I know Patient should always be first!) and I can't imagine space for laying out a half drape etc. Anyway, we use a bucket system and it works, similar to Nurse ellie. I rather like the idea of the disposable hanging bags but I can't see us being able to buy them as (funny) they cost money. In this time of do everything right I am surprised we aren't "on to it" with the bags though.

At least we don't have those awful swab racks that were the very devil to clean .....!!! I am sure there are Theatre nurses out there who remember those times.

I think this is a great site and I just love reading what you all write about. Funny that we all seem to have similar problems and it doesn't matter what part of the world we are in! Maybe we can come up with global solutions to age old problems?

OR male nurse · Mar 14, 2006

With some of the responses I am wondering how big your OR rooms are and what type of surgery you do? I am picturing our OR room when it is packed with equipment, people and the patient (I know Patient should always be first!) and I can't imagine space for laying out a half drape etc.
Hi.. not sure how big our OR rooms are. I know that they are bigger than the hospital across town.. lol. Anyway.. we do a lot of ortho, vascular, OB, dental, etc. We don't do any trauma, heart, or brain surgery. Even when we do a shoulder scope and have all of the stuff pulled around: (Arthrex pump, video tower, bovie, suction, jugs, etc.) we still always have room for a "drop cloth"

Marie_LPN, RN, LPN, RN · Mar 14, 2006

We use a drop cloth for shorter cases, the hanging bags for longer abdominal cases or cases that require a lot of stuff in the room (like endovascular things).

Marie_LPN, RN, LPN, RN · Mar 14, 2006

You can look down at the 1/2 sheet at any time and take a visual count of your sponges and plastic bags and know how many you have.

And visual count is the reason why i never EVER drop sponges in a bucket. Not everyone can see them in the bucket till someone pulls them out, and depending on what's going on, that can be awhile. Plus, anesthesia will take a look at the sponges as well as the suction cannister to estimate blood loss. Sponges are a little easier to see when they aren't piled on top of each other in a bucket.

singe · Mar 17, 2006

I prefer to use the plastic hanging bags for cases where more than 10 sponges are used just to keep them organized and out of the kick bucket. The practice of bundling the used sponges together has bitten me in the but b/4, so have gone to the bags more consistently-better to have them displayed than have to take a bundle apart to find the missing sponge during a count at the end of the case. I hang the tail of the laps over the edge of the pouch to be sure there's only one per pouch, also. If it's drippy, then you can always put a blue pad under and then throw the whole thing into bio-waste when done. Hope this helps.

grimmy, RN · Mar 20, 2006

i, too, prefer the hanging bags. the scrub typically drops them in the kick bucket (which i line with the pack plastic bag at the beginning of the case) and during the case i keep track of them by putting them in the hanging bags. i've only been in a few cases where we had a lap/raytec count greater than 100 (our policy is xray when >70). i find laying out sponges on a sheet to be tedious, and a waste of space. with surgeons/staff moving around the room, and needing clear, safe walking room, the less on the floor, the better. generally speaking, i rarely have to count as many laps as needles, so this is not a huge issue. just yesterday, i had a 160+ needle count, and that was a major pain in the tuckus.

ortess1971 · Apr 9, 2006

We use both a kick bucket and the hanging sponge counters. Sometimes, if there aren't that many sponges, the circulator will drape them neatly over the side of the kick bucket.