Before induction of anesthesiaBefore induction of anesthesia con'tBefore skin incisionBefore patient leaves
Confirm all team members have introduced themselves by name and role.

Patient confirms his/her identity, site, procedure, and informed consent signed.

Surgical site marked by surgeon as indicated.

Patient information confirmed:

  • Pre-operative questionnaire
  • Old chart as indicated
  • Pre-operative labs
  • Glycemic control as indicated
  • Pre-operative pathology
  • Communicate anticipated critical events
  • Allergies
  • Antibiotic prophylaxis

If applicable review below:

  • DVT prophylaxis-anticoagulant/mechanical
  • Essential imaging displayed and confirm intraop. imaging as indicated

Service-specific positioning and support, and expected procedure duration.

Equipment sterility and needs established (e.g. implants).

Confirm availability of intraop. frozen section as indicated.

Monitoring (SpO2, BP, ECG, central +/- arterial line, temp., foley, etc. as indicated).

Anesthesia equipment safety check completed.

Healthy (ASA 1)

If applicable review below:

  • ASA
  • Difficult airway or aspiration risk identified
  • Risk of >500ml blood loss (7ml/kg in children) identified and blood products available as indicated

Carry out a surgical pause:

  • Patient’s name
  • Planned procedure
  • Surgical site
  • “Does anyone have any other questions or concerns before proceeding?

Nurse confirms:

  • Completion of instrument, sponge and needle counts
  • Specimen labelling (read specimen labels aloud, including patient name) and visualize specimen in container
  • Unanticipated events
  • Confirm post-operative destination
    and status
  • “Could anything have been done to make this case safer or more efficient?”

Surgeon/nurse confirms:

  • Procedure
  • Important intraop. events
  • Estimated blood loss
  • Important intraop. events
  • Recovery plans (i.e. postop. ventilation, pain management, fluid balance/management)
  • Estimated blood loss