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Circu Guide Schistosomiasis

The document outlines a surgical procedure checklist, including patient information, consent details, and a prayer for the surgical team. It lists instruments and personnel involved in the operation, as well as pre-operative and post-operative data. Additionally, it includes vital signs and anesthesia information relevant to the procedure.

Uploaded by

Kristine Reign Tiu
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We take content rights seriously. If you suspect this is your content, claim it here.
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26 views2 pages

Circu Guide Schistosomiasis

The document outlines a surgical procedure checklist, including patient information, consent details, and a prayer for the surgical team. It lists instruments and personnel involved in the operation, as well as pre-operative and post-operative data. Additionally, it includes vital signs and anesthesia information relevant to the procedure.

Uploaded by

Kristine Reign Tiu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Baseline C. Time: Initial C. Time: Final C.

Time: Cautery Tip


Instruments, Sponges, Needles # I.C F. C Towel Clips
Peanuts
OS 4x4 Good morning/afternoon/evening OR team! W.H.O. OR Checklist Timeout! Our
Cherries patient's name is__________________________,_____years old, F/M. In for
Lap Sponge ________________________________________ . Consent for procedure and
Atraumatic anesthesia care signed and secured. HBAg result:________ Allergies:_________
Bandage Scissors CP status:__________ With ongoing __________(IV fluid) regulated at ____________.
Mayo Scissors NPO since:_____________
Metzenbaum
Surgical Blade Pre-operative meds given:
Richardson
Army Navy
Bladder Retractor May we introduce the OR team starting with the surgeon:
Surgeon:
Senn Retractor
Assistant Surgeon:
Deaver
Anesthesiologist:
Malleable
Scrub Nurse:
Schnidts
Circulating Nurse:
Mixters
Student Scrub Nurse:
Heaney
Student Circulating Nurse:
Kelly Straight
Kelly Curve
Let us pray:
Allis
Loving Father, we entrust to you the care of our patient this day; guide with wisdom
Sponge Forceps
and skill the minds and hands of the medical professionals who minister in your name,
Babcock and grant that every cause of illness be removed, that she/he may be restored to
Needle Holder soundness of health and learn to live in more perfect harmony with you and those
Blade Holder around her/him, through Jesus Christ, our Lord, Amen.
Tissue Forceps
Thumb Forceps Excuse me Dr..___________________ and the rest of the OR team, baseline counting of
Pean instruments, sponges, and needles is done.
Kochers
OR INFO TIME TEMP PR RR O2sat BP
Case Number:
Name:
Age: Sex: Address:
Operation Performed:

Date:
Time Started: Time Ended:
Type of Anesthesia:
Induction Time:
Surgeon:
Pre-Op Dx:

Post-Op Dx:

_______________________________________________________________________

Time of Arrival:
IV Fluid & Site:
Anesthesia Time:
Sedation:
Intubation:
Extubation:
Specimen Out:

Pre-op VS
BP:
02Sat:
HR:
RR:

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