Assignment task:
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Counting is done differently in many facilities, but there is always a first count done before any case start; except if there is an emergency. A carpal tunnel is pressure on the median nerve and in a carpal tunnel case, the instruments are not counted because the patient is not being opened to where a raytech, lap sponge, or any type of equipment can get lost inside the patient. The items that are being counted at the beginning are the softs which are the raytechs, and lap sponges, next would be the sharps which are 15 blades, carpal tunnel knife, sutures, hypodermic needle and bovie tip.
The surgeon uses a lead hand with a blue towel to place the operating hand on, then he uses a marking pen to mark where he will be making his incision in the palm of the hand, next he uses an Esmarch to wrap around the patient hand up to the elbow. The surgeon uses a knife to make his incision and Adson to grasp the skin, after making his incision he uses a hemostat to do some dissecting and when that is done he takes his carpal tunnel knife and guide to free up the median nerve, next he irrigate in the incision and cleans it with a lap, after that he closes the incision with a 3-0 nylon, xeroform, 4x4's, kerlix, and ace wrap. The last count is done while the surgeon is closing and it starts from the patient, mayo, and to the back table with softs, and sharps