(2) Place stick sponges on sponge forceps for use within a cavity; place
Kitner sponges on curved (Kelly) forceps.
3-15. NEEDLE AND INSTRUMENT COUNTS
a. Accounting for Needles. The scrub and the surgeon should work
cooperatively to make sure that no needle is left in the patient:
(1) Needle counts should be done on a one-for-one basis to the surgeon;
that is, the scrub should receive the needle the surgeon has just used before handing
him another one. If a needle is broken, both parts must be given to the scrub.
(2) At NO time should there be a free needle (one not on a needle holder)
on the Mayo stand or within the operative field.
The scrub should know the number of needles in actual use.
b. Accounting for Instruments. Instrument counts are seldom necessary,
unless it is common practice to count them in the state where the Army hospital is
located or on cases in which instruments might easily be lost.
3-16. CARE OF TISSUE SPECIMENS AND FOREIGN BODIES
a. Handling of Specimens. A specimen is anything surgically removed from
the patient. It may include bone, soft tissue, or foreign body. The improper handling of
specimens may result in a mistaken diagnosis, a delay in treatment, or a second
operative procedure, any of which may jeopardize the life of a patient. The circulator is
responsible for the proper handling of the specimen. He should take the following
(1) Label the specimen container properly, in accordance with local policy.
The circulator must identify the specimen on all the proper forms. A gummed label is
usually completed and placed on the specimen container. In addition, Standard
Form 515, "Medical Record--Tissue Examination," should be filled out in duplicate.
(2) Place the specimen in the appropriate container with the appropriate
solution, usually a ten percent formaldehyde solution for routine specimens. However,
the solution to be used is prescribed by the pathologist.
(3) Give special handling to those specimens requiring it. Always ask the
OR nurse or the surgeon before placing a specimen in the routine solution. Examples
of situations in which specimens may require special handling are as follows:
(a) Some specimens cannot go into the ten percent formaldehyde
solution right away. Tissue for frozen section is one example. It is a specimen
prepared for immediate diagnosis by quick-freezing, cutting a cell-thick layer, and