CST Worst NIGHTMARE

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  • Опубліковано 26 вер 2024

КОМЕНТАРІ • 105

  • @erased84
    @erased84 5 років тому +76

    As someone who's had 50+ surgeries in my life, I wish we could request surgeons/anesthesiologists & surgery techs all around the US. I'd def. pick you as my surgery tech, you seem to care about your patients & I love that.

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому +11

      Truly honored Joe.

    • @braylenwyatt5528
      @braylenwyatt5528 3 роки тому

      I know I'm kinda randomly asking but does anybody know a good website to watch new series online?

  • @Trinity4me
    @Trinity4me 5 років тому +32

    As a new circulating nurse, I appreciate the time you take to make these videos. Good communication is key. Thank you. I always look forward to new videos from you.

    • @ccoop3774
      @ccoop3774 5 років тому +4

      You'll find a system that works for you. Remember to always follow policy. One tip for you- say your lap chole is converting to open, I threw the wrapping for everything I opened onto my table. Then when they are set and working, I went through every wrapper and container I had and updated my counts. I wouldn't yell out for help because all this crap is opened, but I have no clue what the table has. It just confused me more with 2 or 3 people opening up stuff. However, you'll find what works for you. I truly hope you will love it as much as I did! Happy New Year!

  • @saltyfl-clowns1248
    @saltyfl-clowns1248 3 роки тому +7

    I know I’m two years late seeing this; But I’m in Tech school now and I’m my mock surgery portion. My instructor will purposely move an item or drop a suture to see if US techs notice it. He won’t say what he has done until the final count is completed. If we notice it he’ll respond with “Glad to see you’re paying attention.” If we miss it he’ll demonstrate exactly what he did and how we can improve on our awareness. I enjoy that the fact he does is it But also get frustrated when I miss something.

  • @crf450rbulletdavid9
    @crf450rbulletdavid9 4 роки тому +7

    The main surgeon I work with thinks counting is stupid and tells me off when I try to turn away to do a count. He actually tells me off no matter what. It’s an unhealthy relationship.

    • @crf450rbulletdavid9
      @crf450rbulletdavid9 4 роки тому

      Ya’Dad I think he’s warming up to me now. No need for bullets Mr dad. How has your experience been working with surgeons? Mine has been mostly good.

  • @tachaacevedo3247
    @tachaacevedo3247 4 роки тому +7

    Yes, that happened to me as student intern - it was an tubal ligation case. Did a count before the case and the last count at the end we were missing one lap- the doctor already left. We were searching like crazy for that lap- we turn over the garbage - everything. Call back the doctor and he had it in his pocket. Don't know why he had it in his pocket but he did. Lol

  • @laurenelizabeth2592
    @laurenelizabeth2592 5 років тому +8

    Omg... So stressful!! There can be so much pressure on us new techs to get it right. I hope I never have to deal with this but I can see how it happens from time to time...

  • @starfleethastanks
    @starfleethastanks 5 років тому +17

    Currently looking hard into starting ST school. I'm glad I know about these things going in.

  • @undercoloroflaw
    @undercoloroflaw 4 роки тому +16

    OH HELL NO! Lol. There is NO way in hell I would have accepted that count as a circulating nurse. She is standing WAY too far away from the field to SEE the tech counting. I conduct my counts WITH my techs, not across the room. What I just saw here is a count at very high risk for miscount. My practice is two pair of eyes seeing and counting the same items at the same time! In addition, I require my techs to SEPARATE FULLY each lap,pledget, cottonoid and raytec on the field.
    I know, I know--- many techs are insulted and annoyed by this. I used to have a tech that would break the paper ribbon from a pack of laps and she would hold them with thumb and forefinger and "fluff" them at me. Then she would run her fingers over them and say "five laps" at me. Uh---NO! Count them again and separate FULLY each one.
    This tech and I ALWAYS had this issue. She was determined to run the count, HER way. I think it was more of a power struggle for her. Other circulators accepted her way of doing the count but I wouldnt--- so that's why I think she resisted me so much. She wasted so much of MY time trying to get a case off the ground I finally told our boss unless she straightened out this tech on who was in charge in the room---i would no longer work with the tech. THEN other techs started to resist my methodology of counting. It was extremely uncomfortable and produced an extremely and unnecessary high level of tension for everyone in the room. I continued to insist the techs follow my directives during such a crucial step in the process.
    Then it all came to a head with one fatefull open belly case that I began at 0730and turned even uglier as time went on. I was still with the case until the call nurse came to take over at 2015 or so. I called for a handoff count and this tech started mouthing off. This disturbed the surgeon which by this time of night he was understandably angry and cranky, as we all were. Rather than the tech quietly doing the hand off count with me, she made it an issue----he stopped what he was doing, looked at me and said what's the damn problem here? I said we need to do a handoff count---for the call nurse to takeover. He was grumpy and complaining to his assistant and looked back at me and said----forget it! We will count at the close! I pressed him again and asked, So-- you're refusing to allow a handoff count? He confirmed he was refusing. I said, " well I think you should know I will be documenting it as such".
    He only said",yeah, whatever". Which I also documented. The tech just smirked at me. I turned to anesthesia and got their attention to witness my next move. I turned to the call nurse and said", You catch all that?". She nodded yes. I said "ok---'there are 4 lap sponges for which I cannot account---i think they are in the belly. The needles and other sponges are accounted for but obviously all instruments are in question since we are not permitted a handoff----are you ok with this"? She said, yes.
    So, I leave and I'm furious wiith the surgeon AND the tech because a handoff is very important-----as they soon came to learn. Somewhere around 4-8 weeks later, a patient presented to the ER with belly pain. ER doc realizes this patient is a fairly fresh post-op. He orders a flat plate x-ray. Lo, behold and OH SHIT! There's a lap sponge, plain as day, right there in the old belly cavity!!!
    Surgeon requests a moment with me. He apologizes PROFUSELY and swears he will NEVER interfere with how I conduct my counts. He even told me he had been hearing the techs complain about having to count with me because I was such a stickler. He said I really thought you might be a bit overboard but now I know if I hadn't interfered with you, we more than likely wouldn't be here now taking this patient back to surgery!"
    I told him I appreciate d his apology and that I was terribly sorry this happened but that now and then you run across a tech that wants to control things when it isn't in anyone's best interest to allow.
    So----anyone, tech or nurse, let my story be a lesson to the. The RN is responsible for everything that happens in that room. If you don't believe it then you've never been to court. The state board of nursing holds that RN accountable as the OR suite manager and registered authority during that case.
    I have been very fortunate in my 30+ years in the OR to never have a retained foreign object in any of my cases on my watch. I can only make that claim because I never let a tech tell me how to run my counts in a way contrary to protocols and years of experience. I may indeed be a stickler about surgical counts but ya can't argue with my track record of my methods.
    That tech and the nurse who finished out the case that night were in a bad way for sometime over it. It's a terrible feeling and I've known those who quit because they felt so messed up over it.
    The operating room is not child's play, even on its best day. There always tension. Never be intimidated by anyone into doing the wrong thing. The patient is THE most important person in the room----yeah I know---Dr Suchnsuch thinks he is but he's not
    Have a great career----and get along with your co-workers. That is very important

  • @ejpitts22
    @ejpitts22 3 роки тому +2

    Have never been in a case with a RSI (retained surgical item), but you're right about them being "never events". Miscommunication and distractions are major contributors. At least most hospitals now mandate xrays for counts that are unreconciled or discrepant. Team members, especially the scrub and the RN MUST find their voice.

  • @sandravalsaint4347
    @sandravalsaint4347 5 років тому +4

    I thank you for your videos, after watching your videos I registered to become a Surg. Tech. I graduated from the program last year and looking forward to starting my new career. I hope you would make a video on what to expect on the first few days as a new scrub tech.

  • @montanaevans2857
    @montanaevans2857 5 років тому +8

    This happened to my dad a few years ago. He had almost died of sepsis and had months of hospitalization and nursing home care! The surgeon on the case cut 1.5 of his own fingers off during surgery a couple days after operating on my dad. 😬 Had to switch to teaching instead of practicing.
    Fun story for the day. Haha.

    • @kitsunefaye1661
      @kitsunefaye1661 2 роки тому +3

      😳😳😳😳😳 How in the FUCK did the surgeon cut off his fingers!

    • @kohlrabenschwanz
      @kohlrabenschwanz 2 роки тому

      That’s not funny at all. Numbnut

  • @timl1481
    @timl1481 4 роки тому +1

    I work in a dedicated SSD in the UK, I'm one of the guys who decontaminates and sterilises instruments as they come in from the Hospitals. Thank you for producing these excellent videos. Its fascinating and very informative to see what happens during a different part of the process that I don't usually get to experience. Keep up the good work.

  • @noraperez5616
    @noraperez5616 5 років тому +4

    I’ve been a tech for 35 yrs I’ve never had this happen to me, I visually count during surgery to make sure I have everything ready to do my official counts and after my official counts with the circulator I count again as I’m throwing away laps raytecs and putting my instruments back in the trays. I count all the time it only takes seconds, if I’m the assistant I do all of my regular counts and at the end before I put dressings on I count again to myself

    • @rapunzel39
      @rapunzel39 5 років тому +3

      Nora Perez Same here Nora...Also a tech for 35 years who does “unofficial” counts before, during, and after the “official” counts. 😷👍

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому +2

      Kool! I do the same. I' m constantly counting during the case. Observing.

  • @isiahsteele7418
    @isiahsteele7418 4 роки тому +9

    I know of an event where 5 towels (gray at the time) were left in a patient. I know of a event where 5 lap sponges were left or retained in a patient.

  • @meagnelhug9976
    @meagnelhug9976 5 років тому +7

    I had surgery last week and I'm scared now hahaha

  • @lmdmt
    @lmdmt 5 років тому +16

    Who would have to pay for the surgery if the patient has to go back for a RSI?

  • @mgabbzc9009
    @mgabbzc9009 5 років тому +2

    Hi could you please please do a video on how to proceed or change, if gloves become contaminated during the procedure . Like how to change them out and the different types of methods for this ?

  • @jennjatras-rogers1444
    @jennjatras-rogers1444 5 років тому +3

    Thank you for this video.

  • @isiahsteele7418
    @isiahsteele7418 4 роки тому +4

    In all my almost thirty years in practice, fortunately this has never happened. Open hearts to total joints and pelvic fractures to micro surgical muscle flaps.

    • @bebeerin
      @bebeerin 3 роки тому

      what about doing an x-ray due to a miscount?

  • @melissarainchild
    @melissarainchild 5 років тому +5

    This is what one of the WHO's recommendation is for: the out-count. And a mea cupla can be for the surgeon that push speed. The out-cound HAS to be given time...I understand fully.

  • @davidp2888
    @davidp2888 5 років тому +2

    Great video, Shane. I was just checking a few days ago to make sure I hadn't missed one. Happy New Year.

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому +1

      Was trying to find time these last few weeks to shoot something lol. Moving into the new house, Xmas, and new years= no extra time lol. Glad I was finally able to do this video though. I've had it written out for weeks now.

  • @CoronaHero
    @CoronaHero 2 роки тому

    Very important subject! On the lighter side, not sure what's different, but you look amazing!

  • @DrAdnan
    @DrAdnan 5 років тому +6

    It’s interesting how objects still pretty commonly get retained in patients. Nice overview!

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому +3

      Its the one thing in the OR that hasn't really benefited from technology yet.

  • @carasmussen27
    @carasmussen27 5 років тому +3

    the circulating nurse would record the dropped item? I assume it is left until the end. Is that why there is the different color on the laps? Happy New year Shane.

    • @ccoop3774
      @ccoop3774 5 років тому +6

      Depending on the item, it may need replacing. Then you would have the extra item. That's why the circulator needs to pick it up and make note of it. The nurse and/or CST may be relieved out for lunch or end of shift. You want to let the crew coming in know about the dropped item and where it is so as to not sabotage the new crew. The blue strip on the lap pads is radiopaque. It is what would show up on an x ray.

    • @iamblackthorne
      @iamblackthorne 5 років тому

      @@ccoop3774 I wish I had someone like you as my circulating nurse. You rock.

    • @ccoop3774
      @ccoop3774 5 років тому +3

      @@iamblackthorne Thank you very much! I scrubbed and assisted also, so I knew the roles we all have. I have had to clean the room on busy days, too, as well as running upstairs with a stretcher to get a patient. Where I worked, there was no "that's not my job." I worked with a fantastic group of people. I gained so much experience over the years. I had to retire early because of my back. I miss it so much. That's why you see me on these channels. Happy New Year!

    • @iamblackthorne
      @iamblackthorne 5 років тому

      @@ccoop3774 We'll roll you back and forth on a gurney then! 😄 I'm so sorry about your back. 😢 Once I get set up here, you're welcome to observe... on a comfy seat.

    • @ccoop3774
      @ccoop3774 5 років тому

      @@iamblackthorne Oh, thank you! Take care of your back, neck, shoulders, etc. There's not always enough free people to assist with moving the patient. Call can be the worst.

  • @micahconant1084
    @micahconant1084 4 роки тому

    I'm going to start courses to become a cst soon hopefully. Even the simplest of the videos you put up are very helpful

  • @tenzinzenden6156
    @tenzinzenden6156 5 років тому

    Hi, I am one of your new subscriber watched most your videos.very helpful and educational.I can tell you love what you do.thankyou so much for taking your time to do all these videos.really appreciate it.Keep up the good work..👍

  • @71Macola
    @71Macola 5 років тому +2

    I am a newly employed Surg Tech. This is my personal "Panic Mode" nightmare scenario. Some Raytecs and Lap sponges are almost impossible to differentiate when they are soaked with blood!!! I have to develop short-term OCD when it comes to these things!!!

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому +1

      Open them up before tossing them to the kick bucket.

    • @undercoloroflaw
      @undercoloroflaw Рік тому

      NEVER let a surgeon use a towel to stuff in a cavity. We had a surgeon who did that three different times and we had to reopen the patient to remove the towel. Of course we didn't know it was a towel because?....No radio opaque tag. I kept wondering what tech would keep doing that and I finally figured it out. Every time I worked with her, I made her count the towels. I said until you break this habit and learn to give him lap sponges instead, we will count towels. The ONLY time I permit that is if they tag it with a sponge stick, or towel clamp.

  • @MichaelPhillips-gg2jg
    @MichaelPhillips-gg2jg 5 років тому +4

    Wouldn’t it be logical to do an immediate XRay on every single surgery regardless whether or not the post surgery item count is 100% correct?

    • @ccoop3774
      @ccoop3774 5 років тому +4

      Why? If your counts are correct there would be no need to expose the patient and staff to needless radiation.

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому +4

      Logics sometimes are omitted in Surgery. The point in this whole thing is to expose the patient to less radiation. No radiation if at all the better.

    • @bebeerin
      @bebeerin 3 роки тому +1

      no bc unnecessary radiation and additional cost

  • @kitsunefaye1661
    @kitsunefaye1661 2 роки тому

    As a surgical patient and a surgical tech student (starting in October), this is my worst nightmare. I’m with Michael from The Office (huge fan of the show), I’m saying “OH, GAWD! FUCK NO! FUUUUUCK NOOOOOO! OMIGAWD NOOOOO! FUUUUUUUCK!”😳😳😳😳😳😳😳😳😳😳

  • @Tfichtenbaum
    @Tfichtenbaum 5 років тому +4

    how the heck does this happen ? ..no wonder why doctors get sued outta the nose ...I can understand being rushed because of the trauma that happened needs quick reaction but still .. I had an emergency c sections with my son that happened quick because his heartbeat slowed down and I was rushed into the theatre ....nothing was left in me ....how does the patient know they have a foreign body, they get an infection.......

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому +9

      There will always be human error. We go through training throughout the year to try and not let things like this happen...

    • @ccoop3774
      @ccoop3774 5 років тому +3

      He said in the video that with some emergencies there isn't time for the initial count. In those instances a portable x ray is taken at the end to ensure there's no retained sponges or instruments.

    • @ccoop3774
      @ccoop3774 5 років тому +4

      Each facility has policies in place for the surgical counts. We have to make note of who does the counts throughout the surgery. We even had a policy that there had to be a portable abdominal x ray if 30 or more laps were opened. You can bet that if ever a sentinel event like this happens, there will be many meetings, or "root cause analysis" to address the event.

    • @laurenelizabeth2592
      @laurenelizabeth2592 5 років тому +2

      Some suture needles are SO SO tiny you can barely see them to load them in the first place... Very easy to lose if you have a surgeon and three med students in the room

    • @ccoop3774
      @ccoop3774 5 років тому +2

      @@laurenelizabeth2592 true!

  • @Nooorrriii
    @Nooorrriii 5 років тому +14

    Is it the surgical tech’s worse nightmare or the patient’s worse nightmare 🤔

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому +9

      Both for sure.

    • @ccoop3774
      @ccoop3774 5 років тому +2

      The circulator's, too.

    • @kylamcroberts6162
      @kylamcroberts6162 5 років тому +2

      Grievousig101 obviously it’s both. But considering this entire channel is for surgical technologists and there job duties, activities. It’s only “rational” it would be a surgical technologists worst nightmare. We failed. It’s scary enough to have wrong counts. You fell like you failed..but always it’s found or proven that you didn’t leave it in the patient. That’s the most amazing relief. But to have failed as far as it getting left behind in a patient. That’s literally your worst nightmare. Our job is revolved around keeping this from happening amongst many stressful other things. Its all about the patient. It’s common sense neither want this happen.

    • @lovejesuschristlovejesus3398
      @lovejesuschristlovejesus3398 4 роки тому +1

      More the patient

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому

      Both!

  • @daviovann
    @daviovann 5 років тому

    That happen to my uncle back in the 90s.

  • @TheBellecm
    @TheBellecm 5 років тому

    I absolutely love your videos they are very informative. I began at a degree program began with all my prerequisites and moved to a different state. I now feel like my only option is a certificate program at the local schools. I feel like all my maths and English and sciences are wasted. What would you recommend for someone in my position. I began as a CNA and have been in the field for 13 years. I have hospital experience as well as short term care long term care and just love to keep learning and advancing. Surf tech is def for me but I know myself and want to advance to FA.. with a certificate program I feel like It will take me longer. Any advice?

  • @RobMBG
    @RobMBG 5 років тому +5

    Man... my heart was in my throat the entire video! (Well maybe not the office clip lol) I wouldn’t wish this on anyone. Counts. Counts. Counts. Double checks. I hope this never happens to me. Thanks for the great serious video.

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому

      It will not if your'e focusing on your case. Keep your eyes and ears openned. Peripheral viewing is important as well. Organization. Alway keep your countable in view. Never put your lap sponges in the basin on the back table. It's easier to count when exposed to your circulator and yourself.

    • @michelebailey2780
      @michelebailey2780 3 роки тому +1

      Yeah. I've got retained foreign bodies in my neck from thyroid surgery! 3 Titanium clips that I was not informed about beforehand and r now poking at me with every swallow. Very uncomfortable and distressing. Need to get them removed. I'm enjoying your videos. Learning a lot about this regrettable surgery I had.

  • @Crawfordsfive
    @Crawfordsfive 5 років тому +1

    So who is the one that gets suspended? The tech or the nurse? I’m pretty sure it’s not going to be the surgeon.. idk it just seems like the tech is the scape goat that gets punished for any and everything that goes wrong

    • @ccoop3774
      @ccoop3774 5 років тому +4

      The count involves the tech and the nurse. As long as the facility's policies are followed, no one should be suspended. I have had to empty trash cans, crawl on a nasty, bloody floor, but thankfully I found whatever I was searching for over the years.

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому +1

      Not an escape goat. That our responsibility. Some places I've worked demanded that Surgical Tech had or have mal practice insurance.

  • @epicgunreal2336
    @epicgunreal2336 5 років тому +1

    What kind of Instruments are used for a c seccion

    • @isiahsteele7418
      @isiahsteele7418 4 роки тому +1

      Retractors, hemostats, of course scissors, knives, tissue forcepts both toothed and non toothed.

  • @Boddah.
    @Boddah. 5 років тому +2

    It's only a nightmare to them because they fear getting the shit sued outta them.

    • @iamblackthorne
      @iamblackthorne 5 років тому +8

      We don't want patients hurt. What you mentioned is secondary.

    • @ccoop3774
      @ccoop3774 5 років тому +1

      @@iamblackthorne I agree.

    • @iamblackthorne
      @iamblackthorne 5 років тому +1

      @@ccoop3774 Absolutely. Whoever doesn't care about the patient shouldn't be there, IMO.

    • @JohnCrichton
      @JohnCrichton 5 років тому +2

      @@iamblackthorne Meh, I've encountered doctors who know my injuries were caused by other doctors and they let me suffer making some excuse that they don't know how I got the way I was. Most doctors are great, but it's not all secondary to some unfortunately.

    • @iamblackthorne
      @iamblackthorne 5 років тому +1

      @@JohnCrichton I've met doctors like that, too. I do not like them at all... putting it lightly.

  • @cherylmorgan8046
    @cherylmorgan8046 5 років тому

    Do you think its a good idea to count by two or one count when counting, I have seen miscounts due to counting in two rather by ones ?

    • @ccoop3774
      @ccoop3774 5 років тому +4

      Always count by ones!

  • @vyshnavikrishna6761
    @vyshnavikrishna6761 5 років тому +1

    Your Name please dear Surgeon ..

  • @DuramaxL5P
    @DuramaxL5P 5 років тому

    At 9:57, what is a vaginal acorn?

  • @missdollrado
    @missdollrado 5 років тому

    Your so handsome and thanks for explaining things so clearly

  • @paigerideout6996
    @paigerideout6996 5 років тому

    Yikes

  • @munaali9854
    @munaali9854 5 років тому +3

    1st one here

    • @SurgicalTechTips
      @SurgicalTechTips  5 років тому

      You are this videos winner :D

    • @munaali9854
      @munaali9854 5 років тому +2

      Surgical Tech Tips thank you so much for this video even though I am only 10 years old I’ve always wanted to be a type of surgical doctor and your videos always help learn a lot thank you very much.

  • @blindedpolo
    @blindedpolo 5 років тому +1

    Do surgeons in the US give time to nurses and techs to do surgical count especially in time of closing?

    • @ccoop3774
      @ccoop3774 5 років тому +2

      No.

    • @blindedpolo
      @blindedpolo 5 років тому

      c coop so what do you guys do then?

    • @ccoop3774
      @ccoop3774 5 років тому +2

      We count while the doc is closing.

    • @marymcewen6888
      @marymcewen6888 5 років тому +4

      Every time a body cavity or skin layer or tissue layer is closed, you do a count.

    • @blindedpolo
      @blindedpolo 5 років тому

      I mean on instances of missing items, do they give time for the tech and nurses to search?