When initiating closing counts, where should the CST begin?

When initiating closing counts, the Certified Surgical Technologist (CST) should begin at the surgical field. This approach is crucial as it allows for a direct assessment of the instruments and items that have been used during the procedure, ensuring that all are accounted for before closure. Starting the count at the surgical field helps to confirm that nothing has been inadvertently left inside the patient, which is a primary concern in surgical safety.

Beginning the count here allows for a systematic approach, making it easier to verify items that are already present in the field. After ensuring that everything is accounted for in the surgical field, the counts can then progress to the back table and instrument table, where additional items may need to be reconciled. This step-by-step process is essential in minimizing the risk of retained surgical items, thus prioritizing patient safety during the closing phase of surgery.