A system for tracking and locating surgical items and objects in an operating room environment that incorporates two-stage functionality. A first stage provides mechanisms for tracking objects using radio frequency (RF) tags that are positioned on or in conjunction with every surgical item and object so as to be tracked by a number of RF transceivers located about the operating room. In addition to integrating RF ID components, the tags integrate hard spherical components that are easily identifiable by ultrasonic detection. If an object is “lost” from the tracking system functionality (RF tracking), the system operator may review a last known location and movement path presented on a display and thereafter utilize an ultrasonic sub-system in a localized area to detect the exact location of the missing object or item. Narrowing the location of a “lost” object is facilitated by the use of one or more LED laser pointers that are directed through the last known path of the object and to its last known location.