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  • PRE OP Checklist

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    This document is a pre-operative checklist for a patient undergoing surgery at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital in New Delhi. The checklist contains 14 items to confirm important details like obtaining proper consent, completing pre-operative tests and preparations, administering pre-medication and antibiotics, and ensuring the correct patient and procedure. The checklist is signed by both a doctor and nurse to verify all safety measures are addressed before the patient's surgery.

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    PRE OP Checklist 27968162-120a-4b33-897e-a060159d8aee

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    This document is a pre-operative checklist for a patient undergoing surgery at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital in New Delhi. The checklist contains 14 items to confirm important details like obtaining proper consent, completing pre-operative tests and preparations, administering pre-medication and antibiotics, and ensuring the correct patient and procedure. The checklist is signed by both a doctor and nurse to verify all safety measures are addressed before the patient's surgery.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    76 views1 page

    PRE OP Checklist

    Uploaded by

    DR.
    This document is a pre-operative checklist for a patient undergoing surgery at the Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital in New Delhi. The checklist contains 14 items to confirm important details like obtaining proper consent, completing pre-operative tests and preparations, administering pre-medication and antibiotics, and ensuring the correct patient and procedure. The checklist is signed by both a doctor and nurse to verify all safety measures are addressed before the patient's surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Atal Bihari Vajpayee Institute of Medical Sciences and

    Dr Ram Manohar Lohia Hospital


    Baba Kharak Singh Marg, New Delhi-110001

    PRE-OPERATIVE CHECK LIST


    Name: ............................................................................................................................... Age : ................ Sex: ................

    S/o, D/o, W/o: ....................................................................................................................ICU/Ward.......................................

    CR No............................................... MLC No. (If any) ...................................................... Date : ............... Time.................


    Yes No
    1. Right patient for right Surgery...................................................................................

    2. Consent ....................................................................................................................

    Routine .....................................................................................................................

    High Risk...................................................................................................................

    3. PAC...........................................................................................................................

    4. Premedication given.................................................................................................

    5. Preoperative Orders followed ..................................................................................

    6. Blood/Blood products arranged ...............................................................................

    7. Morning investigations (exp. Blood Sugar, Electrolytes),

    if ordered, report attached........................................................................................

    8. Part preparation........................................................................................................

    9. Jewellery, Valuables, Cosmetics (specially nail polish) removed..............................

    10. Investigation reports, including MRI/CT scan attached.............................................

    11. Patient dressed in OT Clothes .................................................................................

    12. Referral Consultations, if any, done...........................................................................

    13. Pre operative antibiotic given ...................................................................................


    or
    Antibiotics are sent with the patient to OT (in Consultation with surgeon I/C)

    14. Surgical safety check list...........................................................................................

    Name & Signature of Doctor Name & Signature of Nursing Staff

    Date & Time: Date & Time

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