A Splash at Closing

In practice

It is late in a long abdominal case. Riley, the scrub person, is wearing a mask but has pushed protective glasses up onto a cap to see the suture better in the dim light. As the surgeon irrigates the wound, the stream hits a pocket of fluid and a fine spray of blood-tinged irrigation reaches Riley's face. Riley feels a drop land in one eye. The field is still open, and Riley's first instinct is to finish the closing count before saying anything. Instead, Riley says plainly that there has been a splash to the eye. The circulating nurse calls for another scrub person to take over. Riley steps back from the field, removes gloves and gown, and goes straight to the eyewash station, flushing the eye with water for as long as the station's instructions say. The relief scrub person completes the count with the circulating nurse. Riley then reports the exposure to the charge nurse, who follows the facility's exposure procedure: an incident report, a confidential medical evaluation, and testing of the source patient's blood with the patient's consent, as policy allows. Riley's hepatitis B vaccination record is already on file. At the debrief, the team talks about the eyewear. The room light was adjusted, and Riley now uses eyewear that does not fog or block the view.