Early on,during the preliminary sponge count on closure of a repair of a ruptured abdominal aortic aneurysm,the circulating nurse was unable to account for 2 lap sponges.He had maintained accountability for all sponges and instruments discarded from the sterile field and bagged each sponge carefully.He immediately turned and addressed the entire team in a clear voice.Select the appropriate communication that the circulating nurse must employ during this count discrepancy.
A) "Stop everything. I'm missing a couple of sponges. They are not in the trash or back table. Check the wound."
B) "I think you are missing 2 sponges. Shall I call X-ray while the scrub person checks her table again? Doctor, please check the incision."
C) "We have a count discrepancy. We started with 70 sponges and find only 68. We are missing 2 lap sponges. Everyone, please check your areas.
D) "I've called X-ray because we are short 2 sponges. I've called the charge nurse to get someone to help me check the trash and linen."

Question

Quizplus · Accepted Answer

Note that the circulating nurse used SBAR format to alert the team of the critical situation.All incorrect closure counts should be reported immediately and attempts made to resolve every discrepancy.If the count remains unresolved,the circulating nurse again notifies the surgeon of the unresolved count.A search of the surgical wound,field,floor,linen,and trash is made for the missing item (thus,the rationale that linen and trash not leave the OR until the end of the procedure).All personnel direct their immediate attention to locating the missing item.If it is not found,an X-ray film may be taken and read by the radiologist or surgeon as specified in institutional policy.

Early On,during the Preliminary Sponge Count on Closure of a Repair