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Retained surgical swabs: possible causes for errors in x-ray detection and an atlas to assist recognition
Abstract:
A swab or pack left in a patient may not be recognised on a radiograph. This will usually be due to poor observation, but errors may result from unfamiliarity with the pattern of the markers. In addition, some markers may be difficult to detect, though this usually applies only to swabs which are very small or to those produced by some continental manufacturers. It should also be realised that, in a very few hospitals, swabs which do not have an opaque marker may occasionally be used in theatre. All the X-ray detectable swabs provided by the major suppliers in the U.K. are demonstrated.
Insights
Radiographs may miss retained surgical swabs due to poor observation or unfamiliarity with marker patterns. This demonstration shows all X-ray detectable swabs from major UK suppliers to improve detection.
Area of Science:
- Medical Imaging
- Surgical Safety
Background:
- Retained surgical swabs (RSS) are a preventable complication in healthcare settings.
- Failure to identify swabs on radiographs can lead to significant patient harm and increased healthcare costs.
- Detection challenges arise from poor radiographic observation, unfamiliarity with marker patterns, and variations in swab characteristics.
Purpose of the Study:
- To demonstrate all X-ray detectable swabs from major United Kingdom suppliers.
- To improve the recognition of retained surgical swabs on radiographic imaging.
- To reduce the incidence of retained surgical swabs through enhanced radiograph interpretation.
Main Methods:
- Compilation and radiographic demonstration of X-ray detectable swabs.
- Inclusion of swabs from major UK suppliers, highlighting marker visibility.
- Discussion of factors affecting radiograph detection, including swab size and manufacturer.
Main Results:
- All X-ray detectable swabs from major UK suppliers are visually represented.
- Variability in marker detectability is noted, particularly for smaller or non-UK manufactured swabs.
- Potential for non-opaque markers or marker-less swabs in rare instances is acknowledged.
Conclusions:
- Familiarity with the appearance of X-ray detectable swabs is crucial for accurate radiographic interpretation.
- Standardized demonstration of surgical swabs aids in preventing retained surgical items.
- Awareness of potential detection difficulties can mitigate risks associated with retained surgical swabs.