Surgical safety checklist

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

BEFORE INDUCTION OF ANESTHESIA (With at least nurse and anesthesiologist)
Has the patient confirmed his/her identity, site, procedure and consent?	❑ Yes
Is the site marked?	❑ Yes ❑ Not applicable
Is the anesthesia machine and medication check complete?	❑ Yes
Is the pulse oximeter on the patient and is it working?	❑ Yes
Does a patient have a known allergy?	❑ No ❑ Yes
Does the patient have difficult airway or aspiration risk?	❑ No ❑ Yes, and equipment/assistance is available
Risk of more than 500 ml blood loss (7ml/kg in children)?	❑ No ❑ Yes, and two IVs/central access fluids are planned
BEFORE SKIN INCISION (With nurse, anesthesiologist and surgeon)
Confirm all team members introduced themselves by name and role.	❑ Yes
Confirm the patient's name, procedure, and where the incision will be made.	❑ Yes
Has antibiotic prophylaxis been given within the last 60 minutes?	❑ Yes ❑ Not applicable
Ask the surgeon about anticipated critical events.	❑ What are the critical or non-routine steps? ❑ How long will the case take? ❑ What is the anticipated blood loss?
Ask the anesthesiologist about anticipated critical events.	❑ Are there any patient-specific concerns?
Ask the nursing team about anticipated critical events.	❑ Has sterility (including indicator results) been confirmed? ❑ Are there equipment issues or other concerns?
Is essential imaging displayed?	❑ Yes ❑ Not applicable
BEFORE PATIENT LEAVES THE ROOM (With nurse, anesthesiologist and surgeon)
Nurse verbally confirms the name of the procedure.	❑ Yes
Nurse verbally confirms completion of instrument, sponge and needle counts.	❑ Yes
Nurse verbally confirms specimen labeling (read specimen labels aloud, including the patient's name).	❑ Yes
Nurse verbally confirms whether there are any equipment problems to be addressed.	❑ Yes
The surgeon, anesthesiologist and nurse are inquired about any key concerns for the recovery or the management of the patient.	❑ Yes