WHO Surgical Safety Checklist

Prior to Induction of Anaesthesia Prior to Skin Incision Prior to patient leaving the
operating theatre
SIGN IN TIME OUT SIGN OUT
 Patient Confirmed  Confirm all team members have  The name of the
- Identity introduced themselves by name and procedure recorded
- Site role  That instrument, sponge
- Procedure  Surgeon, Anaesthesia professional and needle counts are
- Consent and nurse verbally confirm: correct (or not applicable)
 Site marked/not applicable - Patient  How the specimen is
 Anaesthesia safety check - Site labelled (including
completed - Procedure patient’s name)
 Pulse oximeter on patient and - position  Whether there are any
functioning  anticipated critical events equipment problems to be
 surgeon reviews: What are the addressed.
critical or unexpected steps  Surgeon, anaesthesia
operative duration, anticipated blood professional and nurse
loss? concerns for recovery and
 Anaesthesia team reviews: are there management of this
any patient-specific concerns? patient?
 Does patient have known  Antibiotic Prophylaxis given within
allergy? the last 60 minutes?
_ Yes _ Yes
_ No _ Not applicable
 Difficulty Airway/Aspiration Risks  Essential Imaging Displaced?
_ No _ Yes
_ Yes and Equitable _ Not applicable
_ Assistance Available _ Other Checks
 Risk of >500cc blood loss (7cc in
children)
_ Yes
_ No
 PRAYER BEFORE A PROCEDURE 12. Position the patient.
13. Supplies foot stools if needed.
Heavenly Father, we believe that 14. Does the sponge count with the
You are truly present in Your midst scrub nurse.
today. As we begin our work, make use 15. Watches forehead for
of us as Your instrument of LOVE and perspiration.
HEALING to others. Guide us in all our 16. Fills out required operative
decisions and actions especially in this records completely and legibly.
particular operation. Bless (NAME OF 17. Remains in the room as much as
PATIENT) so that whatever we do, in possible to be constantly
thought, word or action may bring about available.
Your LOVE and HEALING to him/her for 18. Watches surgery, anticipates
Your greater Honor and Glory. We ask needs.
You this through the intercession of 19. Sees that the surgical team is
Jesus, Your Son and the Blessed Virgin supplied with necessary item to
Mary, our Mother. Amen. perform the operation efficiently.
20. Uses equipment and supplies
economically and conservatively.
RESPONSIBILITIES OF A 21. Directs cleaning of the room and
CIRCULATING NURSE preparation for the next
operation.
1. Functions as the overseer of the
room during the procedure to
maintain sterility. RESPONSIBILITIES OF A SCRUB
2. Assists the entire team and the NURSE
patient.
3. Send for patients at appropriate 1. Sets up sterile supplies and
time. instruments.
4. Receives, greets, identifies the 2. Assists the surgeon as needed
patient. throughout the surgery.
5. Checks chart for completeness. 3. Assists in draping the patient in
6. Assists patient in moving safely the field.
to operating table. 4. Assists in gowning and gloving.
7. Assists the anaesthesiologist 5. Hands instruments, sutures,
when requested, stays with sponges, etc... as needed in
patient during induction. efficient manner.
8. Ties the scrubbed members’ 6. Keeps operative field tidy during
gowns. case.
9. Checks operating room lights in 7. Wipes blood from instruments.
advance for good working order, 8. Keeps close watch of needles,
turns lights on at appropriate time instruments and sponges so that
and adjust when needed. none will be misplaced or lost.
10. Prepares operative site. 9. Keeps accurate
11. Connects catheter to drainage instrument/needle count.
bottle, or catheterize if desired by 10. Supplies sterile dressing
the surgeon. materials.
11. Discards soiled linens into
hamper after checking it for
instrument.
12. Cares for all instruments and
supplies LEFT AFTER CASE.
PRINCIPLES OF ASEPTIC
TECHNIQUE
1. All articles to be sterilize should
be clean and free from foreign
particles, hair, dust, dirt or
discharge of any kind.
2. All materials must be sterile
before it comes in contact with a
sterile area. Sterilized articles
become unsterile when they
come in contact with any
unsterile object or material.
3. Dressings and sponges once
removed from the sterile
container due considered
contaminated.
4. Covers of containers corks from
bottle etc... when removed and
placed on an unsterile surface,
should be placed with the sterile
side up so as to prevent
contamination from the unsterile
surface. When held in, they
should be held with the sterile
side down. This helps to keep air
contamination to a minimum.
5. If in doubt as to the sterility of an
article, it should be considered
unsterile.
a. If a sterile looking package
is in a non-sterile area, it should
be unsterile.
b. If the actual timing of an
autoclaves lead is uncertain, it
should be autoclaved and re-
timed.
c. If an unsterile person
brushes a sterile table, the table
should be considered unsterile.
6. Wrappers on sterile packages
should be of a double thickness
and of sufficient size so that the
package may be opened without
contamination or contaminating
rather any part of the contents of
the package.
7. Sterile packages should have
identification as to sterility and
contents.
a. Sterile and unsterile
articles should not be stored
together.
b. Sterile packages should
be dated on marked with a moist
heat indicator to denote sterility.
8. The edges of anything that
encloses sterile contents are
considered unsterile.
a. In opening sterile
packages, the ends of flaps are
secured in the hand so they flaps
are secured in the hand so they
do not dangle loosely.
b. The last flap of a sterile
package is pulled towards the
person opening the package
thereby exploring the package
contents away from the non-
sterile hand.
c. Flaps on peel-open
packages should be pulled back
not torn, to expose sterile
contents.
d. If a sterile wrapper is used
as a table cover, it amply covers
the entire table surface, only the
exterior and surface level of the
cover are considered sterile.
OR STAFF
Balisi M. Hamilig, RN, MSN
Sheila Paulasa, RN
Nelson B. Valdepenas, RN, MPA
Romeo A. Felipe, RN
Jayson Val A. Buduan, RN
Debbie A. Taguba, RN, MSN
Rei Marc Cipriano, RN
Jalan Neil C. Moralit, RN
Judy Heizel Asuncion, RN
Christopher D. Javier, RN
R-mie Mar De Laza, RN
Manuel S. Cortez III, RN
John Paul Balisi, RN
Lionel Christian D. Gallibu, RN
Richelle Lhyn I. Tallow, RN
Abigail Ann R. Soriano, RN
Del Marie Bautista, RN
URO
Dr. Manuel David Hipolito
ANAESTHESIOLOGISTS
Dr. Visitacion D. Pinson
Dr. Eligio M. Capio
Dr. Ma. Angelicita D. Capio
Dr. Joan T. Barangan
Dr. Tarcila B. Lagayan
Dr. Jennifer L. Saludez
Dr. Fe Angelica T. Alvarez
Dr. Reymundo M. Blancaflor
Dr. Edwin A. Taguinod
Dr. Cesar B. Cating
Dr. Marisa T. Verzosa
Dr. Maria Asucion R. Hipolito
Dr. Harold Banez
Dr. Rashelle Lopez
Dr. Sherwin Rebivez
Dr. Mirabelle M. Diaz
OB
Dr. German Tan – Cardoso
Dr. Jose Dante Marcos
Dr. Grace Marie Marcos
Dr. Marivic Tuddao
Dr. Ma. Imelda Garbajal
Dr. Ellen Mary De Guzman
Dr. Cristy Corpuz
Dr. Shahreza Baquiran
Dr. Criseline Tolentino
Dr. Maricel Palattao
Dr. Claire Gonzales
Dr. Amelita Mamba
Dr. Fritzie Josue
Dr. Lovela Usal
Dr. Divina Gracia Arellano
Dr. Michelle Sera
Dr. Christiana Calagui
Dr. Pua
Surgery
Dr. Edwin Baguinon
Dr. Jherome Pascual
Dr. Pinky d. Beran
Dr. Salvador Beran
Dr. Narciso Chan
Dr. Jose Alfredo Fonacier
Dr. Sergio Mamba
Dr. Jomar Marcelo
Dr. Domingo Matammu
Dr. Rolando Mesde
Dr. Frederick Pua
Dr. Franco Rommel Reyes
Dr. Francis Ignacio
Dr. Dominadoe Centeno
Dr. Odessa B. Tiangco
Dr. Aziz Santican
EENT
Dr. Enouel Steve Battung
Dr. Dhelia Macaiba – Bernani
Dr. Lydia Chan – Binuluan
Dr. Rafael De Guzman
Dr. Angelito Madrid
ORTHO
Dr. Anthony Abogado
Dr. Joegy Llanes
Dr. Nicolo Mamba
Dr. Marc Paolo Lasam
Dr. Angel Cayetano
ABBREVIATIONS
ROI – Removal of Implant
CSM – Cataract Senile Mature
HCVD – Hypersensitive Cardiovascular
Disease
ITP – Idiopathic Thrombocytopenic
Purpura
TURB – Transurethral Resection of the
Bladder
TURP – Transurethral Resection of the
Prostate
ECCE – Extracapsular Cataract
Extraction
PCIOL – Posterior Chamber Intraocular
Lens
PSARPT – Posterior Sagittal Anorectal
Pull Through
URS – Uteroscopy
SBE – Stone Basket Extraction
BOO – Bladder Outlet Obstruction
IOC – Intra Operative Cholangiogram
POA – Post- Operative Adhesions
CLEA – Continuous Lumbar Epidural
Anesthesia
GETA – General Endotracheal
Anesthesia
PHRA – Partial Hip Replacement
Arthroplasty
RMMA – Poly Methyl Metacrylic Acid
FESS – Functional Endoscopic Sinus
Surgery
SAB – Subarachnoid Block
APR – Abdomino Perineal Resection
CRD – Chronic Renal Disease
TUI – Transurethral Incision
UVJ – Uretero – Vesicle Junction
PL – Peritoneal Lavage
PFC – Perineal Fluid Cytology
PO – Partial Omentectomy
BLND – Bilateral Lymph Node
Dissection
TBW – Tension Band Wiring
DJ Stenting – Double Junction Stenting
CAG – Colloid Adenomatous Goiter
TKR – Total Knee Repalcement
PL – Peritoneal Lavage
IIH – Indirect Inguinal Hernia
PL – direct Laryngoscopy
SSSI – Superficial Surgical Skin
Infecton
DMF – Distal Mucoid Fistula
RGP – RetroGrade Pyelography
PPUD – Perforated Peptic Ulcer
Disease
TIVA – Total Intravenous Anaesthesia
GALMA – General Anesthesia
Laryngeal Mask Airway
LMA – Laryngeal Mask Airway
CHSF – Compression Hip Screw
Fixation
APR – Abdominoperineal Resection
R – right
L – left
S/P – status post
T/C – to consider
LSCS – Low Segment Caesarean
Section
BTL – Bilateral Tubal Ligation
“E” – Emergency
EL – Explore Laparotomy
PUFT -
TAHBSO – Total Abdominal
Hysterectomy Bilateral Salphingo
Oophorectomy
PEA – Polypectomy, Ethmoidectomy,
Arthotomy
CGO – Complete Gut Obstruction
PGO – Partial Gut Obstruction
AKA – Above the Knee Amputation
BKA – Below the Knee Amputation
CBDE – Common Bile Duct Exploration
IOC – Intra-Operative Cholangiogram
MPI – Multiple Physical Injury
BPA – Benign Prostatic Hypertrophy
ICBC – Iliac Crest Bone Grafting • Fascia
TBW – Tension Band Wiring • Muscle
ESWL – Extra Corporeal Shock Wave • Peritoneum
Lithothripsy
RAEF – Roger Anderson External
Fixation SURGICAL NEEDLES
ORIF – Open Reduction Internal By the Shaft:
Fixation • Straight – used generally on the
MRM – Modified Radical Mastectomy Skin
BPH – Benign Prostatic Hypertrophy • ½ circle – mostly internal to skin
Lap Chole – Laparoscopic
• 3/8 circle – skin, plastic surgery
Cholecystectomy
EL – Exploratory Laparotomy
By the eye:
DL – Direct Laryngoscopy
• Eye present – will require
SSSI – Superficial Surgical Skin
threading
Infection
DMF – Distal Mucoid Fistula • Lack of eye – the needle and
suture are one unit
Ostomy – opening Note: either double arm-two needles,
Ectomy – removal atraumatic or traumatic)
Plasty – repair
FE/SE – Stool Exam/ Fecal Exam By the point:
UA/BUA – Uric Acid • Cutting – spear or trocal
FBS – Fasting Blood Sugar • Round – tapered point
U/A – Urinalysis
CTT – Chest Tube Thoracostomy
UTZ – Ultrasound OR INSTRUMENTS:
HBT – Hepatobillary Tree
KUB – Kidney Urether Bladder (Full FORCEPS
Bladder) • Mixter
BBL – Bone to Bone – Ligament • Kocher forcep (straight and
MTB – Muscle to Bone - Tendon curve)
IVP with contrast – Kreatinine • Tissue forcep (with teeth)
Decrease CBC – risk for bleeding • Thumb forcep ( without teeth)
Increase WBC – infection • Russian tissue forcep (long and
Total Cholesterol Tryglyceride – NPO 6- short)
8 hours • Adson- with and without teeth
Choledochotomy – the opening of the • Multiple teeth
common bile duct to remove stones • Single-tooth
R Hemicolectomy – resection of the R
• Ferris-Smith
half of the colon
• Forester sponge forcep

LAYERS OF TISSUE/ABDOMEN RETRACTORS

• Skin • Harrington retractor
• Subcutaneous • Army-navy retractor
• Deaver retractor
 • Ribbon (malleable) retractor
• Richardson retractor (baby and
big)
• Weitlaner retractor
• Gelpi retractor
• Beckman retractor
• Balfour abdominal retractor
• Spring wire retractor
• Vein retractor
• Mayo abdominal retractor
• Crile retractor
• Harrington retractor
• Non-self-retaining retractor
SCISSORS
• Thorek-Feldman scissors
• Suture scissors
• Mayo scissors (straight, curved,
long)
• Metzenbaum scissors (long,
curved, straight)
• Stitch scissors
• Steven tenotomy scissors
• Steven iris scissors
• Corneal scissors (left and right)
• Wescott scissors
• • Kevorkian-Younge endocervical
CLAMPS
• Straight Glassman noncrushing
intestinal clamp
• Bobcock clamp
• Allis clamp
• Kocker (ochsner) clamp
• Backhaus towel clamp (large and
small)
• Mosquito (Halsted) clamp
• Kelly clamp (straight and curve)
• Crile clamp (straight and curve)
NEEDLE HOLDERS
• Webster needle holder
ACCESSORY INSTRUMENTS
• Frazier suction tip
• Buie probe, groove director
INSTRUMENTS FOR DILATATION
AND CURRETAGE
• Auvard vaginal speculum
• Jackson vaginal retractor
• Schroeder-braun uterine
tenaculum
• Schroeder uterine tenaculum
• Straight museux uterine
vulsellum forceps
• Goodell uterine dilator
• Sims uterine sound
• Curtic tissue forcep
• Bozeman uterine packing forceps
• Forester sponge forcep
• Fletcher-Van Doren uterine polyp
forcep
• Hank uterine dilator
• Hegar uterine dilator
• Pratt uterine dilator
• Sim sharo curette
• Heaney uterine curette
• Thomas dull uterine curette
curette
MINOR ORTHOPEDIC SURGERY
INSTRUMENTS
• Skin hooks
• Senn retractor
• Rake (Volkmann) retractor
• Meyerding finger retractors with
blade
• Inge lamina spreader
• Heiss retractor
• Freer elevator
• Key periosteal elevator
• Brun (Spratt) curette (size 3-0)
• Mouse curette (double ended)
• Maltz-lip sett nasal rasp
 • Carroll tendon passing • T-wrench
• Kern bone-holders • Philips screw-driver
• Hike osteotomes • Straight screwdriver
• Zimmer stainless steel mallet • Stille-Mosley bone cutting forceps
• Zimmer bone cutting forceps • Lane bone holding forcep
(double action) • Bishop bone clamp
• Kleinert-Kutz rongeur (double • Wire cutter
action) • Multiaction pin cutter
• Solid Gigli saw handles with Gigli
INSTRUMENTS FOR MAJOR saw blade
ORTHOPEDIC SURGERY
• Sofield retractor
• Hibbs retractor SUTURES
• Meyerding retractor Absorbable Non-absorbable
• Bennet bone elevator retractor Plain 2/0 Prolene 0
• Israel rake retractor Plain 3/0 Prolene 7-0
• Leksell bone rongeur PDS II 0 Prolene 3-0
• Jansen-Zaufel bone rongeur Chromic 2-0 Mersilk 0
• Echlin bone rongeur Chromic 1 Mersilk 3-0
• Lowman bone holding clamp Chromic 0 Mersilk 2-0
• Bone hook Chromic 3/0 Ethilon 10-0
• Kep periosteal elevator Chromic 4/0
• Crego periosteal elevators Vicryl 4-0
• Ferris – Smith tissue forcep Vicryl 5-0
• Brun bone curette (straight and
SUTURE COLORS
angled)
Prolene – Blue
• Hohmann retractor
Ethilon – Green
• Bone chisel Mersilk (Silk) – Black
• Smith-Peterson osteotomes Vicyl – Violet
(curved and straight) Pbs – All Nylon
• Zimmer bone mallet Chromic – Brown
• Zuelzer awl Plain –
• Kiene bone tomp Monocryl – dark blue
• Maltz nasal rasp
• Universal file
• Kerrison cervical rongeurs
• Cushing pituitary rongeur
(straight and curve)
• Hand drill with Jacobs chuck key
• Zimmer drills bits
• Sadle – nosed pliers
• Standard pliers
• Vise-grip pliers
• Traction bow