Radiologists in search of lost needles find some, lose some

Radiologists approached by nurses looking for missing surgical needles should ask for the needle size and request a tabletop radiographic technique, according to a study presented at the American Roentgen Ray Society meeting.

Dr. Jay A. Hudson and colleagues from the Tripler Army Medical Center in Honolulu conducted several experiments to determine the best radiographic technique for finding needles. They also determined the smallest needle size visible on x-ray.

The researchers first placed needles ranged from the smallest size (11-0) to the largest (3-0) on a copper plate and x-rayed them. All of the evaluating radiologists - 12 board-certified practitioners and 13 residents - identified all the eedles between 8-0 and 3-0.

When the needles were placed in phantoms, the radiologists again found all needles between 8-0 and 3-0. Accuracy ranged from 98% for 4-0 needles to 0% for 11-0 needles. The radiologists found 6-0 and larger needles relatively easily. But they rarely found needles smaller than 8-0, Hudson said.

The radiologists preferred the standard tabletop x-ray technique with a grid over the bedside portable without a grid.

Hudson reported that residents found more needles than staff radiologists, but they also had more false positives.

"Unfortunately, some radiologists found needles that weren't there," Hudson said.