Surgical Safety Checklist
Before induction of anaesthesia
(with at least nurse and anaesthetist)
Before skin incision
(with at least nurse, anaesthetist and surgeon)
Before patient leaves operating room
(with at least nurse, anaesthetist and surgeon)
Has the patient confirmed his/her identity, site, procedure, and consent?
Yes
No
Is the site marked?
Yes
Not applicable
Is the anaesthesia machine and medication check complete?
Yes
No
Is the pulse oximeter on the patient and functioning ?
Yes
No
Does the patient have a
Known allergy ?
No
Yes
Difficult airway or aspiration risk ?
No
Yes, and quipment/assistance available
Risk of >500ml blood loss (7ml/kg in children) ?
No
Yes, and two IVs/central access and fluids planned
Confirm all team members have introduced themselves by name and role.
Yes
No
Confirm the patient's name, procedure, and where the incision will be made.
Yes
No
Has antibiotic prophylaxis been given within the last 60 minutes ?
Yes
Not applicable
Is essential imaging displayed?
Yes
Not applicable
Anticipated Critical Events
To Surgeon
What are the critical or non-routine steps?
How long will the case take?
What is the anticipated blood loss ?
To Anaestherist
Are there any patient-specific concerns ?
To Nursing Team
Has sterility (including indicator results) been confirmed ?
Are there equipment issues or any concerns ?
Nurse Verbally confirms:
The name of the procedure
Completion of instrument. sponge and needle counts
Specimen labelling (read specimen labels aloud, including patient name)
Whether there are any equipement problems to be addressed
To Surgeon, Anaesthetist and Nurse:
What are the key concerns for recovery and management of this patients?
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