Product News

Don't Just Count Sponges, Account for Them
A simple and inexpensive system to prevent retained objects.

SPONGE ACCOUNTING Throughout surgery, the circulating nurse places used sponges in the easily visible hanging holders, each containing 10 pockets. At the end of the procedure, each pocket should contain a sponge, whether used or not.

Manually counting the sponges a surgeon uses in a procedure is highly unreliable. In recent years, electronic tracking systems that use bar-coded or radiofrequency-tag-equipped sponges (tinyurl.com/o5vtn3l) have made it easier to verify counts and prevent retained objects, yet not every OR employs them. Could accounting for sponges, not just counting them, be the answer?

Sponge ACCOUNTing — the letters are capitalized for emphasis on accountability and accounting — is a system that involves hanging plastic blue-backed sponge holders and a wall-mounted dry-erase board to record the surgical counts in a standardized manner so everyone can see how sponges are being used. The process is centered on the question: "Where are the sponges?" rather than ?"What's the count?"

Sponge ACCOUNTing requires that OR staff manage all sponges in multiples of 10. Throughout surgery, the circulating nurse places used sponges in easily visible hanging sponge holders, each containing 10 pockets. The blue-backed sponge holders hang on racks attached to designated IV poles. You use a separate holder for each sponge type.

"At the end of the operation, you must have 1 sponge in each of the pockets of the sponge holder, whether they are used or unused," says surgeon Verna C. Gibbs, MD, director of NoThing Left Behind, an independent national surgical patient safety project trying to prevent retained objects. "You don't have to count each sponge; you just look at the holders. If there is an empty pocket, you have a problem, and that patient can't leave the OR until the sponge is found."

You can download free signage from the NoThing Left Behind website (nothingleftbehind.org) to provide colorful visual cues and memory joggers. There is a rack sign and an OR safety rules sign (both reminding staff, "Where are the sponges?"). An Incorrect Count Checklist guides team members through the best practices to use when they identify that a sponge is missing. Sponge ACCOUNTing can work in concert with new technology detection systems that use radiofrequency-tagged sponges.

Staff keep a running total of the sponges added to the surgical field on the wall-mounted dry-erase board, which should be easily visible from anywhere in the room. During the procedure, they place used sponges in a clear plastic bag-lined receptacle, such as kick buckets or ring stands.

You take each discarded sponge from the receptacle, opening it to ensure you have only 1 sponge. Fold it into an oval and put the sponge in one of the bottom pockets of the holder. Continue loading the holder, 1 sponge per pocket. Don't mix different types of sponges within one holder. Load from the bottom up because if you're missing a sponge at the end of the case, it's easier to see an empty pocket from anywhere in the room if it's one of the top 2 pockets. If you load top down, you'll have an empty pocket at the bottom of the holder, which is hard for everyone else to see. At the final count, the surgeon and nurses look at the blue-backed sponge holders and see that every pocket has a sponge. This is the show-me step when the team can see there are no empty pockets.

— Gail Guterl

Fast and Accurate Knee Positioning
The SpeedBump knee positioner from Surgical Devices attaches to any operating table in minutes. The patient's foot is placed on the positioner's circular pad, which surgeons adjust using a simple-to-operate foot pedal to automatically change the leg's extension and flexion. Surgeons are in complete and direct control of the SpeedBump, freeing the rest of the surgical team to focus on other tasks. And unlike some other static patient positioners, the SpeedBump remains connected to the patient, saving staff time and effort. Because the device attaches to the underside of the table and works under the sterile field, it doesn't have to be sterilized.
surgicaldevices.com

3D Head-Mounted Display Puts Endoscope's Images in Surgeon's Sightline
It's still awaiting FDA approval, but Sony's head-mounted endoscopic monitor, which wraps around the eyes and shows video so it appears at the size of a virtual movie screen, looks like something your surgeons will love. A gap at the bottom of the device lets the wearer view both the images inside the head-mounted monitor as well as the actual areas of surgery with the smallest of eye movements. The 1280 x 720p resolution panels offer 3D imaging if the scope is so equipped, as well as picture-in-picture and image management capabilities. The external image processing unit accommodates 2 cable-connected wearable monitors, enabling an assistant's view. Sony introduced the product in Japan in August.
sony.com/medical

Single-Use Laparoscopic Smoke Filter
The Purple Surgical Smoke Filter from Alleset enables safe, simple and effective removal of surgical smoke with 99.99995% filtration efficiency. This sterile, single-use smoke filter uses activated charcoal to ensure the removal of noxious chemicals and related odor. A thumbwheel clamp allows convenient, rapid, surgeon-controlled smoke clearance. Sold in boxes of 25.
$15 to $18 ' alleset.com