Tracking Surgical Supplies in the Operating Room

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Surgeons sometimes forget to remove sponges and other surgical aids from the insides of their patients. New tracking technology is now being used to help operating-room nurses keep track of the material used in procedures.


From NPR News, this is ALL THINGS CONSIDERED. I'm Debbie Elliott. Every once in a while, people go to the hospital for surgery and come home with an unwelcome souvenir, something like a sponge or a scalpel that's been accidentally left inside them. To stop that from happening, surgeons are now testing a new way to keep track of sponges and instruments, using tiny radio tags. NPR's Nell Boyce reports.

NELL BOYCE reporting:

The idea that a surgeon might leave something behind inside a patient's body is perfect fodder for a medical drama like Grey's Anatomy.

(Soundbite of Grey's Anatomy)

Unidentified Man (Actor): (As Character) Dr. Bailey, do you see that?

Ms. CHANDRA WILSON (Actor): (As Dr. Miranda Bailey) Oh, my ever-loving...

Unidentified Man: (As Character) We need to open her up.

BOYCE: In this scene, the horrified doctors realize that a large towel is the cause of a woman's chest pain. After it's removed, the fictional patient is distraught.

(Soundbite of Grey's Anatomy)

Unidentified Woman (Actor): (As Character) Who would do that? (unintelligible)

Dr. ALEX MACARIO (Anesthesiologist, Stanford University School of Medicine): It's kind of embarrassing for everyone that works in the operating room.

BOYCE: Alex Macario is a real anesthesiologist.

Dr. MACARIO: To try to explain to a patient's family why it is that their loved one has gone home with a sponge or even a metal instrument.

BOYCE: Macario works at Stanford University School of Medicine. He says studies suggest that this kind of thing happens around 1,500 times a year in the U.S. The foreign objects can cause pain or infection. That's why operating-room nurses carefully count every sponge, instrument, and clamp before a patient gets closed up, but counting isn't foolproof.

Dr. MACARIO: I mean, imagine having to count 45 pennies. I mean, if you do it 10 times, you're probably going to get it wrong once. And when you're counting 45 sponges or 80 sponges, you're probably going to get it wrong once every now and then.

BOYCE: A few years ago, a nurse named Sharon Morris wondered if it would be possible to track sponges with something called an RFID tag. That stands for radio frequency identification. The tags are already being used for everything from inventory control to finding lost pets. They work by emitting a unique pattern of radio waves. The technology is now being modified for surgical sponges by a company called Clear Count Medical Solutions.

The idea is that at the end of a procedure, a surgeon will just wave a special wand over a patient's body. If a tagged sponge is inside, the wand will beep. Alex Macario tested some of the prototypes with the help of eight patient volunteers and two surgeons who played a little game of hide-and-seek.

Dr. MACARIO: Once the surgical procedure was finished, we gave the sponge to one of the two surgeons, and the other surgeon turned away. And the surgeon with the sponge sort of hid it in the inside the patient's open abdomen.

BOYCE: The surgeon who had looked away then turned back and waved the wand over the patient's body. It worked perfectly every time. Whenever the wand passed over a tagged sponge, it beeped. The study appears in the Archives of Surgery.

Dr. VERNA GIBBS (Surgeon, University of California, San Francisco): I think that it's a very good first step.

BOYCE: Verna Gibbs is a surgeon at the University of California, San Francisco.

Dr. GIBBS: But testing the devices in real circumstances is what the next step would be.

BOYCE: Gibbs runs a project called No Thing Left Behind, which is looking at ways to stop the problem of forgotten surgical instruments. She thinks it will take time to see whether this kind of technology could ever replace counting.

Dr. GIBBS: Maybe with these new devices, it's not important to have an absolute number anymore. All we care about is whether or not, at the end of the case, there's nothing in the patient.

BOYCE: But she says there's still technical challenges. Some items, like needles, are too small to tag, and she thinks even with new technology, people will still make mistakes. A surgeon could wave the wands too far away or simply forget to check. Nell Boyce, NPR News.

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