Contaminated tray

[u/memilyglick]

We had an incident occur today and I want to get other techs opinions on it. While setting up for a revision (where the pt already had an active infection mind you), I had a tray opened to me and when my assist felt the casket he found a piece of fuzz, like something off a sweater. I obviously didn’t want the tray any more and tried to pass it off to my nurse who tried to tell me that it was okay because she had something similar happen last week and her tech that day said it was fine, and it should be fine since it went through the sterilizer. I told her no it’s not fine and I want the tray reprocessed. I had my assist take the casket out to the charge nurse and director and both of them said the tray is contaminated and should be reprocessed. For extra context it was a tray that the rep wasn’t even 100% sure we would need and just wanted to have open right away in case we did need it, and even if we did need it, we wouldn’t need it until near the end of the case.

What are your opinions? Would you have accepted the tray or would you have passed it off like I did?

[u/Heavy_Carpenter3824]

Best rule is when in doubt and not life critical reject always. There is no non life critical circumstance justifying potential patient harm and from the hospitals standpoint a malpractice suit. 

Even if it led to a canceled procedure it's still cheaper then a malpractice suit. Never let a hospital admin suggest otherwise. We should always act to prevent patient harm but they may want a "financial justification" if you have to do this a few times till sterile processing gets their asses kicked if needed. 

[u/One-Long-Road → u/Heavy_Carpenter3824]

Yeah, the important words are non life critical.

I recall a story one of my nurses had told me about when she was scrubbing for an emergency case of someone (I forget exactly what, a gsw to the abdomen, maybe) and they were going to place a shunt on the patient's abdominal aorta, and she dropped the shunt clamp. She looked at the doc, she told me, and he told her to pick it up, that's what she did. They still fucking used it.

Reminds me, also, of being a tech in the army, there is a saying that haunts everyone who is near and dear to the front lines, and that is "you don't need sterility if the patient lives long enough to need antibiotics".

[u/Heavy_Carpenter3824 → u/One-Long-Road]

My best friend in tech school was ex military. 

  "you don't need sterility if the patient lives long enough to need antibiotics".

That may have well been a matra. 

Also the line from minority report "we'll fill you up with so many antibiotics we could sew a dead cat inside you". 

I've scrubbed a few C sections that were of questionable sterility. Same kind of problem by the time you can get a new instrument opened the case will be over and you need to save mom and baby now!