NoThing Left Behind®: A National Surgical Patient-Safety Project to Prevent Retained Surgical Items

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Retained Miscellaneous Small Items





These items include fragments or broken parts of instruments, stapler components, parts of laparoscopic trocars, guidewires, catheters and pieces of drains that have been retained. One characteristic of some of these items is that they are often made of plastic and contain multiple parts. Often only one part of the item has a radiographic marker and it is possible that upon separation of the item a non-radiographic piece may be left. Guidewires inserted as part of central line placements have not uncommonly been lost in vessels and require interventional radiographic retrieval. 

There are no standardized practices that can be applied to prevent loss of this wide array of items. In the OR, all surgical items returned to the surgical technologist from the field should be inspected for completeness. AORN has guidelines and most hosptials have policies which require this inspection however there are a huge number of instruments and objects used during cases and it is important that surgical technologists remain familiar with how these items work and come apart so they will be able to detect missing pieces.