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