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As I began reading this, two things popped into my head. No sponge count? Not counting is different than not documenting that you counted. Both are errors. Only one is dangerous.
Second, when I hear about missing instruments I immediately think of a trauma case in an obese patient. When you have a trauma like multiple gunshot wounds there is no time to count instruments before surgery. Hell, there's no time to wash your hands properly. The guy is trying to bleed to death while two or three surgeons are up to their elbows in blood clamping vessels and throwing stitches. It is easy to lose instruments in a big trauma case.
The question for the "victim" is; "Would you rather we take our time and carefully count all our instruments (twice) while you bleed to death?"
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My work here is nearly finished.
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