Communication & Surgical Set Up

A surgical technologist observes a medication error during a procedure that is corrected before causing patient harm. When assisting with the incident report, which of the following should the CST include?

• Personal opinions about what caused the error

• Detailed account of the event, including time, people involved, and corrective actions taken

• Recommendations for disciplinary action against the circulator

• Emotional impact the event had on the CST

Which of the following scenarios qualifies as a sentinel event, and why?

• A. A patient receives a small superficial burn from overheated laparoscopic equipment and is treated before discharge.

• B. A patient returns to the operating room because a surgical sponge was left inside the abdominal cavity.

• C. A verbal disagreement between the surgeon and anesthesiologist is witnessed by the CST.

• D. A preference card is missing an instrument needed for the case, delaying the start time by 10 minutes.

During surgery, the left ovary and tube are removed. The CST confirms with the surgeon before handing the specimen to the circulator, who mistakenly labels it as the right ovary and sends it to pathology. The error is discovered two hours later. What should the team do?

• Call pathology, correct the label, and avoid reporting the error since the specimen isn’t processed yet

• Notify the surgeon and pathology, document the error, and complete an incident report per policy

• Have the surgeon correct it in the op report but skip the incident report unless legal action is taken

• Let the patient's doctor explain the mistake to the patient directly

During a procedure, lidocaine HCl is drawn into a syringe for the Mayo stand and poured into a medicine cup for the back table. What is the correct action the CST must take?

• Label only the syringe, since it’s used more frequently

• Label only the medicine cup if the syringe is used right away

• Label both the syringe and the medicine cup clearly and separately

• Skip labeling if the scrub tech drew up the medication themselves

During the final closure of a laparotomy, the CST and circulator begin the last count. The surgeon is actively closing the skin layer when the team realizes one suture needle is unaccounted for. What is the first appropriate step the CST should take?

• Wait until skin closure is complete to avoid disrupting the surgeon’s rhythm

• Inform the surgeon immediately and request a cavity check

• Check the trash bag for the missing needle

• Have the circulator call for an X-ray without informing the surgeon yet

During a cholecystectomy, the sponge count is off by one lap sponge. The team re-counts but still cannot find the missing sponge. What should happen next?

• Remove all trash bags from the room and start a new count

• Document the error and allow the procedure to continue without further delay

• Notify the surgeon, halt closure, and begin a systematic search of the field and room

• Assume it’s a miscount and continue closure if the cavity appears clear

An emergency C-section is performed without a formal initial count due to the urgent condition of the fetus. After delivery, the team begins organizing for closure. What should they do now?

• Proceed with closure since the patient is stable and there were minimal instruments used

• Perform a full count starting at the back table and document that the initial count was omitted

• Only count sponges, as instruments and sharps are less likely to be retained

• Wait until the case is over to retroactively estimate what was used

Which of the following best meets infection control standards for eye protection in the OR during a procedure with splash risk?

• Prescription glasses with side shields

• Safety glasses with a face shield

• Indirectly vented, anti-fog goggles

• A surgical mask with a plastic face visor

A CST is assisting with a procedure using intraoperative fluoroscopy. Which of the following is the correct sequence of attire to maintain both radiation safety and sterility?

• Surgical gown, then lead apron

• Lead apron, then surgical scrub, then sterile gown and gloves

• Sterile gown and gloves, then put on lead apron and thyroid shield

• Scrub jacket, then surgical gown, then lead apron under gloves

Which of the following equipment should the surgical technologist have available for an ORIF case?(select 3)

• Bovie

• Harmonic scalpel

• Pneumatic tourniquet

• Light source

• Xrayable OR bed