Bar Codes Keep Surgical Objects Outside Patients 269
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."
RFID (Score:5, Informative)
Or they could try using Checklist instead. (Score:2, Informative)
I'm cringing... (Score:5, Informative)
I've been on Slashdot long before I ever started medical school and I always knew people talk out of their element here, but medicine is what I do and I've cringed quite a bit.
Very simply, depending on hospital policy, there are a number of scrub nurses who keep a count of sponges. They are removed in packs of 5, counted, recounted, and checked by at least two team members. As sponges are removed, they are packed in groups of 5 and discarded. A running tally is kept on a white-board by someone who isn't scrubbed in. Albeit mistakes do happen once in a while, but they are very rare.
This system seems quite complicated and I don't see any advantage in an OR, but this will ease the general public because it uses some fancy technology. What most of the public doesn't remember is doctors/surgeons are humans too. We can make mistakes so we have numerous people double-checking counts. Adding additional steps into the process with bar-code scanners only complicates things and introduces further possibility of errors. I prefer things the old fashioned way. Then again, most of my colleagues are also hell bent on sticking to the old ways.
Oh and Slashdot... please stop with the non-sense. Most of you are software or hardware nerds. You're not lawyers, doctors or surgeons. Leave the arm-chair medicine to someone more qualified such as my colleagues. Honestly, some of these comments are embarrassing.
Re:Somehow I find this unlikely... (Score:4, Informative)
Most importantly, a procedure as documented normally extends beyond the core activity itself. The paperwork is often part of it, or at least the basic checks e.g. "have we left any sponges in the body?" If the surgeon had to leave immediately due to some other emergency, everyone else doesn't suddenly assume the procedure is over. There's still the anaesthetist, the nurses, etc. If everyone leaves before counting the sponges, and complications developed, then it would be fair to say at any subsequent inquest that the procedure was not completed, and the shit hits the fan.
Second, "accounted for" tends to get a bit loose as well. Often it doesn't mean physically verified, but simply noted e.g. "Sponge 4 - stolen by bizarre lunatic who came in, grabbed the sponge, and ran out shouting "I've got the flag!". Or simply "Sponge 4 - lost" could technically be accounted for. Clearly "lost" in the context of surgery is rather more important than that of a stock check of frozen fish in a supermarket, and therefore there may be all sorts of checks in place. But at the end of the day, life has to move on, and any bureaucratic system eventually gives someone the authority to sign something off, no matter how important. "Missing, presumed dead" is a classic example.
One of the reasons behind many scandals (insert your politically prejudiced example here) is that things get signed off without due authority, or done in secrecy, or there is no inquest to check exactly *how* things were accounted for, and so on. But the goal is generally: we have a procedure that we know works, everyone has to follow it, and relevant paperwork done. If it is followed and things go horribly wrong, you're much less open to blame if you've followed procedure, and if it is not followed you might find yourself in deep shit *even if* the core activity was performed as well as could be.
As an IT guy with many of the classic failings, I often forget this and assume that simply because I've done a good job, then my work is done. This has (and will no doubt again) come to bite me in the ass when e.g. a hard drive failure leads to making a site visit that could have been avoided if I'd all the paperwork handy to cover said ass.
In the case of surgery, which is a high risk activity conducted by highly trained and experience staff in a controlled environment, I would expect that the instances of the procedure not being completed are rare and the initial statement is damn near 100% true in the "physical" sense, not just the "bureaucratic" sense.
Re:Anything. (Score:4, Informative)
Instruments make up the bulk of the "things" used in a procedure. The emerging tech for tracking those is called dot peen marking. It's mostly designed to help the Central Supply staff (who clean and sterilize equipment) keep their sets together and track where things are in the overall process.
Re:A 39 cent solution (Score:5, Informative)
Believe it or not even with these safeguards there are mistakes made that leave sponges, etc. in patients. Now if the counts by the nurses are incorrect you never finish closing or leave the room without an xray of the surgical site to make sure the lost sponge isn't in the patient. In most cases of sponges left in patients the counts were correct. Example: you used 30 sponges, one is hidden in the surgical site, but when the nurses count they say they have all 30. Not likely but it happens. The only time I have ever left anything in one of my patients the counts were correct, ugh!
There were approximately 28.5 million surgical procedures performed in 2004, if there are 1500 such incidents that leaves an incidence of
Just helping to add some facts to this discussion!
Re:A 39 cent solution (Score:3, Informative)
I should mention that everything that could possibly get lost inside a patient is radiopaque. That is, it'll show up on an x-ray. In the current system, in the extremely rare case that you can't find something, you can take a film to see where it is. So again, this doesn't really give you anything new except a higher price tag.