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Bar Codes Keep Surgical Objects Outside Patients
Reservoir Hill writes "Every year about 1,500 people in the US have surgical objects accidentally left inside them after surgery, according to medical studies. To prevent this potentially deadly problem, Loyola University Medical Center is utilizing a new technology that is helping its surgical teams keep track of all sponges used during a surgical procedure. Each sponge has a unique bar code affixed to it that is scanned by a high-tech device to obtain a count. Before a procedure begins, the identification number of the patient and the badge of the surgical team member maintaining the count are scanned into the counter. When a sponge is removed from a patient, it is scanned back into the system. A surgical procedure cannot end until all sponges are accounted for."
We all make mistakes, but surgeons today should have enough skill to ensure that objects are not left in the body in the first place. It seems like another scenario where use of advanced technology replaces basic skills that a human should have in these situations.
I'd prefer a doctor operating one me to pay attention to the patient not pause to remember if this was the 16th sponge he took out or if the 16th was the one he took out 10 minutes ago.
So until you have a medical degree and the years of on the job experience that it takes to even set foot in a surgery, you don't get to call anyone an idiot that does.
Doing otherwise makes you look like a typical fat,lazy, IGNORANT armchair skeptic who can't even be bothered to use the slightest bit of brain power their pathetic brain is capable of mustering.
If you mod me down, I will become more powerful than you can imagine....
I have enough trouble getting these things to scan under ideal conditions at the grocery store let alone after being pulled used and bloodied from the body of a patient.
Sanity is a sandbox. I prefer the swings.
Hell, sometimes they just get the wrong patient/records (take your pick).
If they get the right paperwork - they can operate on the wrong side. My mother is a nurse (30+ years), and her advice is to make sure you permanent-marker the correct area before they get you ready for your surgery.
As for leaving stuff in your sewn up body ~ it happened to my grandmother 4 times.
I guess you have underachievers, alcoholics, and newbies in every profession.
Just -1, Troll talking to another.
they're too busy doing surgery to worry about counting the number of sponges. but really, think of the number of surgeries that are done every year vs how many actually have this sort of thing happen. surgeons could probably go through hundreds of surgeries without anything remaining in a patient that wasn't supposed to be there and there's always that one time... anything that reduces the probability of harm to those going through surgery is a good thing, it's not perfect but it's improving and that's always a good sign,
Sigs are too short to say anything truly profound so read the above post instead.
I work at a Level 1 trauma center and we do indeed use RFID sponges. Currently we are only using them on a trial basis for trauma surgeries, but I would guess that once the cost drops some, we will infact use them for all surgeries. The RFID wands cost about $50.($135 patient cost). Sponges are bad, but the body will encapsulate them after awhile....retractors on the other hand....I don't know how the hell you leave something 1 foot long and 1.5 inches wide in someone...that boggles the mind. As someone said earlier though, when you have multiple surgeons, multiple residents, multiple scrub techs and circulators, things will get missed. Ofcourse the worst thing is what people call it when something is left in a patient or something goes wrong, a "surgical misadventure" that is just wrong.
let alone after being pulled used and bloodied from the body of a patient. .. in the middle of a critical surgery ..
I think that an RFID would be great too. Have one on each surgical instrument and after everything is complete and you're ready so sew them back together you run a quick scan over the person's body to check for any RFID. That might be over generalized since I'm not a doctor, but I'm sure that everyone here gets the idea.
"Some books contain the machinery required to create and sustain universes."-Tycho
If you truly think that, then you should probably read this eye-opening article: The Checklist.
Meh. Previously, they were supposed to keep count of how many they inserted. If they forget to scan one on the way in, same problem. What they ought to do is open packs of 10 at a time. If they don't have 10 or 20 (clean and used) when they're done, then they know they have a problem. They could recycle the unused ones by sending them to some orderlies to repack them into 10s, and verify it by weight. $300 for a good electronic balance, and they have a system that will actually work. Sometimes low-tech is the appropriate solution.
So you believe something mission critical should rely on single redundancy, since only stupid people make mistakes?
I hope you are being sarcastic. If you weren't, and if your job in any way impacts public safety, please resign immediately.
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How do you scan a bar-code on a sponge designed to soak up blood and yuck? That might be the high-tech part of the scanner.
Bar codes aren't high-tech, but applying them to a number of discrete objects in a highly variable environment with a lot of occlusions and weird angles to solve a very relevant medical problem IS novel and definitely worthwhile.
He may have an ego, but nothing he has said is wrong.
All the doctor would have to do is to equip his assistant with an abacus. Insert a sponge, move a bead right. Remove a sponge, move a bead left. Multiple rows for tracking multiple items, each row labeled. No barcodes, no lasers, no expensive machines.
The idea is to reduce the manpower needed to track the sponges. In a messy abdominal surgery, or open heart, you'll go through dozens. Being able to say "it's spong 12345, that was from the pack we opened last" is amazingly helpful to finding the missing sponge, and it's a lot less labor intensive than counting and double checking when the double counting is liable to introduce its own miscounts either way.
Well then, those specialist surgeons can peel off maybe ten of the thousands of dollars they're making per hour in that operating room to hire a semi-literate guy to watch the operation on closed-circuit TV and count sponges going in and out of the patient.
Or, I don't know, maybe instead of relying on unskilled labor they could come up with an automated solution to an apparently simple yet safety-critical task? Which is the sort of thing that machines are better at anyway? I mean would you rather trust your sponge count to a machine or to a dude who is doing the job to get booze money? Which is the whole point of the fucking article.
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In our OR, sponges come in packs of 10. They are counted by the surgical scrub (a graduate of a 12 to 18 month technical program) and an RN (usually a college graduate) together. I have seen cases where there could absolutely be no lost sponge (i.e., small incision on an arm or leg), yet the sponge count is incorrect. This can result from either incorrectly counting the sponge at the beginning of surgery, or someone careless throwing out a sponge with a surgical towel or gown. Although I have seen surgeons go back into patients when a sponge count is incorrect at the end of surgery, more often it is the result of a miscount or throw-away. The bar-code technique mentioned above will only work if all codes are scanned at the beginning of surgery. Unfortunately, I don't see this a practical, as it would take many minutes to scan all sponges and instruments, and at $600/hour per operating room (hospital staff and equipment), it will raise costs too much. RFID tags are an interesting solution, as long as none of the tags stop functioning, and current counting methods are retained.
I have an idea, call me a radical. You take a slip of paper and two bowls. You count the sponges before the operation, and write the number on the paper and put the paper and the clean sponges in bowl 1. You put the used sponges in bowl 2. The operation cannot be completed until the number of sponges in the bowls matches that on the piece of paper. Come on, folks, why do you need a bar code scanner, how does that make this easier? The only advantage of the scanner is that it prevents doctors from lying and saying they counted them -- apparently it's a real possibility, or they would just count them.
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Why, because he said that if you aren't a doctor you aren't qualified to discuss whether a particular addition to surgical procedure is meritorious? And that if you aren't a lawyer you should avoid giving out legal advice?
/. This happens to have become my specialty, through a long and winding road. I'll admit that it doesn't require quite as much specialist training, but modern money management is complex stuff. Yet all the time on /. I read people getting the basics wrong, and with great fervor (like a recent conversation regarding stock market yields and the inflation rate where a poster came to the conclusion that nobody but Warren Buffett makes money in the stock market). I get called an idiot when I correct them. It makes me laugh.
That's not ego, it's simply the truth. In both cases, you are dealing with incredibly complex fields that contain a lot of specialist information. People spend 4 years _preparing_ to study these, and then another 4 years _studying_ them, and then years of internships, etc, before anyone will trust you to work on/for them unattended. I think because we have access to so much information right at our finger tips, we tend to forget that we aren't the specialists. I've learned enough about medicine to spot common diseases and to use the proper terminology to describe my symptoms. But you know what? If I'm sick and it doesn't go away after a week, I go to see a doctor I trust.
On a side note, I see this a lot whenever economics or investment comes up on
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