Professional Documents
Culture Documents
Hip Replacement Pref Card
Hip Replacement Pref Card
Name of Patient: Asuncion Rosas Magallanes Age: 77 Sex: F Civil Status: Married
Date of Admission: 10/13/17 Time Started & Ended: 1:18-4:00 PM
Date of Surgery: 10/13/17
Bed #: 3052 Hospital No: 17-130000065352 Admission No: 17J00405
Position: Supine
Equipment Used for Positioning: Surgical table, pillow, armboards
Incision: Vertical incision
Skin Preparation: from waist area to the sole of the foot
Disinfectant used: Betadine
Drapes used: Disposable Hip Set
Sign In Time Out Sign Out
Is the patients identity, YES Time Out: 3:40 PM Nurse verbally confirms:
site, procedure and The name of the YES
consent CONFIRMED? Patient, Asuncion Rosas Magallanes procedure to be
Is the surgical site YES scheduled for Hip Replacement recorded
marked? surgery under spinal+general If instruments, YES
Is the anesthesia machine YES anesthesia. sponges, sharps
and medication chart and needle
checked? Surgeon is Dr. Braganza, assisted by counts are
Is the pulse oximeter YES Dr. Tayag, Dr. Baylon complete
attached and working? Anesthesiologist is Dr. E. Braganza Has the specimen been YES
Equipment needed YES Scrub nurse is Ernest Palma, labeled correctly?
available and working? Circulating Nurse is Marie Joy C. (including patients name)
Acasio. Patient was given Cefoxilin. Specimen: NONE
Instruments counted and complete,
you may now proceed Pathologist: NONE
Any equipment problems NONE
identified?
Any concerns for transfer NONE
Does the patient has any: to recovery and
Known allergies NO management issues
Difficult
airway/aspiration risk?
Risk of blood
loss
Has the Surgical Site YES
Infection (SSI) bundle
been undertaken?
Antibiotic
prophylaxis within the
60 minutes
Patient warming
Hair
removal/shave site
Glycemic
control
Has venous YES
thromboembolism
prophylaxis been
undertaken?
Is essential imaging YES
displayed?
Is the initial count done YES
and recorded?
FDAR
Date and Time Focus
10/13/2017 Risk for bleeding D: Patient is to undergo hip replacement surgery
A: > Monitor Vital signs and Heart rate.
>Assess for PTT or APTT prior to surgery
> Evaluate the patients use of any medications that can
affect hemostasis(e.g, anticoagulants, salicylates, NSAIDs,
or cancer chemotherapy).