Surgical Technologist how-to
How to Perform a Surgical Count
Counts prevent retained surgical items, one of the most serious preventable errors in surgery.
Counts prevent retained surgical items, one of the most serious preventable errors in surgery. In short: perform; separate; count, then complete the remaining steps below.
Step by step
Perform the initial count with the circulator before the incision, counting aloud and viewing each item together.
Separate and count sponges one at a time, confirming each sponge’s radiopaque marker.
Count sharps, needles and instruments per facility policy and record on the count board.
Add any items opened during surgery to the count immediately.
Count again before closing a cavity, before closing the skin and at any change of personnel.
Report discrepancies immediately so the team can search and, if needed, obtain an X-ray.
Safety reminders for surgical technologists
- Maintain sterile technique and speak up about any break in sterility
- Pass sharps using a neutral zone or with clear communication
- Use smoke evacuation for electrosurgery to reduce exposure to surgical plume
- Follow counts and time-out protocols on every case
Key terms
Sterile field · Scrub role · Circulator · Back table · Mayo stand · Surgical count: see the full surgical technologist glossary.