NCCT Case 11

During a Caldwell-Luc, the surgical tech passes a long laparotomy tape to the surgeon to be placed in the throat as a throat pack. This will ensure blood does not enter the airway. At the end of the procedure, the surgeon finishes the case without removing the throat pack.

What is the surgical tech’s responsibility in tracking and documenting throat packs or other surgical items?

The role of the surgical tech is to communicate with the circulator any sponge that was placed within the body. The surgical tech can also use a sterile pen to write on the back table how many countable items were placed within the body. It is also the role of the surgical tech to verify the surgeon removed the throat pack at the end of the procedure.

What could have been a potential consequence if the throat pack had remained in place?

The throat pack could have become lodged in the throat, even if the patient still needed to be extubated. This would have resulted in an airway emergency.

How can the surgical team establish a verification process to prevent retained throat packs in ENT surgeries?

Ensure that all team members in the room were told that a throat pack was in place. It should be written on a board where all team members can see that a throat pack was placed. Sponges should be included in the closing count, which would include the throat pack sponge.