Introduction to the Operating Room
LESSON 3: Safety in the Operating Room
3-14
3-14. SPONGE COUNT
a. Discussion. In order to account for all sponges, thus ensuring that none have been accidentally left in the patient, a sponge count is taken at least three times:
(1) By the personnel who wrap sponges or place them in a surgical pack for sterilization.
(2) By the circulator, scrub, and registered nurse (RN) immediately before surgery begins. The circulator then records the sponge count.
(3) By the circulator, the scrub, and RN, and again when the surgeon begins the skin closure. A sponge count may be taken three times during an operation, as in a cesarean section when the sponge count is made before the uterus is closed and again before the abdominal incision is closed, and again as the surgeon is closing the skin. A registered nurse always witnesses the count of sponges in the OR.
b. Repeating the Count. There should be no interruptions while the sponge count is being made. If there is any doubt about the count, it must be repeated.
c. Measures Taken During Surgery. During surgery, loss of sponges may be prevented by various methods. Measures to be taken by the scrub and the circulator include those listed in ((1)-(2), below). Additional measures may be used depending upon local policy or the preference of the surgeon.
(1) Sponges used for the patient's skin preparation are not radiopaque. The circulator is to remove those sponges from the immediate operative area and to secure them in a conductive bag.
(2) Place stick sponges on sponge forceps for use within a cavity; place Kitner sponges on curved (Kelly) forceps.
