CST Surgical Counts & Documentation 1 — Questions and Answers
Question 1: When should the initial surgical count be performed?
- After the patient is draped and before the first incision (Correct answer)
- After anesthesia induction but before patient positioning
- After the first incision is made
- After the surgeon scrubs in but before patient arrival
Correct answer: After the patient is draped and before the first incision
The initial count is performed after the sterile field is established and before the first incision to create a baseline accounting of all items.
Question 2: Which categories of items are included in a standard surgical count?
- Sponges only
- Sponges and sharps only
- Sponges, sharps, and instruments only
- Sponges, sharps, instruments, and miscellaneous items (Correct answer)
Correct answer: Sponges, sharps, instruments, and miscellaneous items
Standard surgical counts include sponges, sharps (needles and blades), instruments, and miscellaneous items such as vessel loops and umbilical tapes.
Question 3: Who is responsible for performing surgical counts in the OR?
- The surgeon and anesthesiologist
- The scrub technician alone
- The scrub technician and the circulating nurse together (Correct answer)
- The circulating nurse and the charge nurse
Correct answer: The scrub technician and the circulating nurse together
Surgical counts are a shared responsibility between the scrub technician and the circulating nurse, who perform the count simultaneously and concurrently.
Question 4: How must sponges be counted to ensure an accurate surgical count?
- Counted in groups of five as packaged
- Individually, with each sponge separated and visually verified (Correct answer)
- Weighed on a scale to estimate quantity
- Grouped by size before counting
Correct answer: Individually, with each sponge separated and visually verified
Sponges must be counted individually and separated from each other so each one is visually confirmed, preventing hidden items from being overlooked.
Question 5: What action must be taken immediately if the final count before wound closure is incorrect?
- Proceed with closure and document the discrepancy post-operatively
- Notify the surgeon immediately and search the field before closing (Correct answer)
- Perform an X-ray only if the surgeon requests it
- Re-count once and proceed if the count remains incorrect
Correct answer: Notify the surgeon immediately and search the field before closing
An incorrect count requires immediate notification of the surgeon and a thorough search of the surgical field, drapes, and surrounding area before wound closure to prevent retained items.
Question 6: Why are surgical sponges manufactured with radiopaque markers embedded in them?
- To make them more visible on the sterile field during use
- To allow detection by X-ray imaging if inadvertently retained in the patient (Correct answer)
- To differentiate sponge sizes during counting
- To comply with color-coding standards for OR supplies
Correct answer: To allow detection by X-ray imaging if inadvertently retained in the patient
Radiopaque markers embedded in surgical sponges allow them to be detected on X-ray imaging, serving as a safety backup in case a sponge is inadvertently retained.
Question 7: At which additional intraoperative point must a surgical count be performed beyond the opening and closing counts?
- Every 30 minutes throughout the procedure
- Before closure of any cavity within a cavity (Correct answer)
- Whenever the surgeon changes gloves
- Only when the scrub technician requests one
Correct answer: Before closure of any cavity within a cavity
A count must be performed before closure of a body cavity within a cavity (e.g., before closing the uterus within the peritoneal cavity) to prevent items from being trapped in an inner space.
CST Surgical Counts & Documentation 1
When should the initial surgical count be performed?