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Archive Staff & Patient Safety 2020

High-Tech Sponge Detection

This reassuring technology ensures no item is left behind after the surgeon closes the incision.

Joe Paone

Joe Paone


DOUBLE CHECK Sponge detection and tracking technologies confirm that traditional manual counts are correct.

Years ago, Valerie Y. Marsh, BSN, MSN, DNP, CNOR, was sure a sponge had been left inside a patient. "The surgeon swore it wasn't in there, and he wasn't going to reopen the incision to find out," recalls Ms. Marsh, a clinical assistant professor at University of Michigan School of Nursing in Ann Arbor. "I said, 'Listen, it's got to be in there. It's no place else. Can we at least get an X-ray?' So we did, and sure enough, it was there."

Nowadays in University of Michigan's ORs, it's not necessary for nurses to request that surgeons X-ray in this case. They can immediately determine if a sponge is unaccounted for by using high-tech sponge detection systems that leverage the use of special sponges containing either barcodes or radiofrequency (RF) tags to confirm an accurate count, every time.

Both barcode and RF technologies are very good and reliable, but they do have differences, according to Robert M. Cima, MD, a colon and rectal surgeon who is a professor of surgery at Mayo Clinic in Rochester, Minn. He characterizes the barcode system his institution uses as more of an accounting or inventory system, where sponges are scanned in and out to confirm the count, while RF systems employ a wand or mattress topper that can detect sponges left inside the patient or accidentally tossed in the trash.

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