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WHO Surgical Safety Checklist

Prior to Induction of Anaesthesia Prior to Skin Incision Prior to patient leaving the
operating theatre
 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
_ 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
1. Functions as the overseer of the
room during the procedure to
2. Assists the entire team and the NURSE
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 c. If an unsterile person
hamper after checking it for brushes a sterile table, the table
instrument. should be considered unsterile.
12. Cares for all instruments and 6. Wrappers on sterile packages
supplies LEFT AFTER CASE. should be of a double thickness
and of sufficient size so that the
package may be opened without
PRINCIPLES OF ASEPTIC contamination or contaminating
TECHNIQUE rather any part of the contents of
the package.
1. All articles to be sterilize should 7. Sterile packages should have
be clean and free from foreign identification as to sterility and
particles, hair, dust, dirt or contents.
discharge of any kind. a. Sterile and unsterile
2. All materials must be sterile articles should not be stored
before it comes in contact with a together.
sterile area. Sterilized articles b. Sterile packages should
become unsterile when they be dated on marked with a moist
come in contact with any heat indicator to denote sterility.
unsterile object or material. 8. The edges of anything that
3. Dressings and sponges once encloses sterile contents are
removed from the sterile considered unsterile.
container due considered a. In opening sterile
contaminated. packages, the ends of flaps are
4. Covers of containers corks from secured in the hand so they flaps
bottle etc... when removed and are secured in the hand so they
placed on an unsterile surface, do not dangle loosely.
should be placed with the sterile b. The last flap of a sterile
side up so as to prevent package is pulled towards the
contamination from the unsterile person opening the package
surface. When held in, they thereby exploring the package
should be held with the sterile contents away from the non-
side down. This helps to keep air sterile hand.
contamination to a minimum. c. Flaps on peel-open
5. If in doubt as to the sterility of an packages should be pulled back
article, it should be considered not torn, to expose sterile
unsterile. contents.
a. If a sterile looking package d. If a sterile wrapper is used
is in a non-sterile area, it should as a table cover, it amply covers
be unsterile. the entire table surface, only the
b. If the actual timing of an exterior and surface level of the
autoclaves lead is uncertain, it cover are considered sterile.
should be autoclaved and re-
OR STAFF Dr. Marivic Tuddao
Balisi M. Hamilig, RN, MSN Dr. Ma. Imelda Garbajal
Sheila Paulasa, RN Dr. Ellen Mary De Guzman
Nelson B. Valdepenas, RN, MPA Dr. Cristy Corpuz
Romeo A. Felipe, RN Dr. Shahreza Baquiran
Jayson Val A. Buduan, RN Dr. Criseline Tolentino
Debbie A. Taguba, RN, MSN Dr. Maricel Palattao
Rei Marc Cipriano, RN Dr. Claire Gonzales
Jalan Neil C. Moralit, RN Dr. Amelita Mamba
Judy Heizel Asuncion, RN Dr. Fritzie Josue
Christopher D. Javier, RN Dr. Lovela Usal
R-mie Mar De Laza, RN Dr. Divina Gracia Arellano
Manuel S. Cortez III, RN Dr. Michelle Sera
John Paul Balisi, RN Dr. Christiana Calagui
Lionel Christian D. Gallibu, RN Dr. Pua
Richelle Lhyn I. Tallow, RN
Abigail Ann R. Soriano, RN Surgery
Del Marie Bautista, RN Dr. Edwin Baguinon
Dr. Jherome Pascual
URO Dr. Pinky d. Beran
Dr. Manuel David Hipolito Dr. Salvador Beran
Dr. Narciso Chan
ANAESTHESIOLOGISTS Dr. Jose Alfredo Fonacier
Dr. Visitacion D. Pinson Dr. Sergio Mamba
Dr. Eligio M. Capio Dr. Jomar Marcelo
Dr. Ma. Angelicita D. Capio Dr. Domingo Matammu
Dr. Joan T. Barangan Dr. Rolando Mesde
Dr. Tarcila B. Lagayan Dr. Frederick Pua
Dr. Jennifer L. Saludez Dr. Franco Rommel Reyes
Dr. Fe Angelica T. Alvarez Dr. Francis Ignacio
Dr. Reymundo M. Blancaflor Dr. Dominadoe Centeno
Dr. Edwin A. Taguinod Dr. Odessa B. Tiangco
Dr. Cesar B. Cating Dr. Aziz Santican
Dr. Marisa T. Verzosa
Dr. Maria Asucion R. Hipolito EENT
Dr. Harold Banez Dr. Enouel Steve Battung
Dr. Rashelle Lopez Dr. Dhelia Macaiba – Bernani
Dr. Sherwin Rebivez Dr. Lydia Chan – Binuluan
Dr. Mirabelle M. Diaz Dr. Rafael De Guzman
Dr. Angelito Madrid
Dr. German Tan – Cardoso ORTHO
Dr. Jose Dante Marcos Dr. Anthony Abogado
Dr. Grace Marie Marcos Dr. Joegy Llanes
Dr. Nicolo Mamba
Dr. Marc Paolo Lasam
Dr. Angel Cayetano

ABBREVIATIONS DJ Stenting – Double Junction Stenting

ROI – Removal of Implant CAG – Colloid Adenomatous Goiter
CSM – Cataract Senile Mature TKR – Total Knee Repalcement
HCVD – Hypersensitive Cardiovascular PL – Peritoneal Lavage
Disease IIH – Indirect Inguinal Hernia
ITP – Idiopathic Thrombocytopenic PL – direct Laryngoscopy
Purpura SSSI – Superficial Surgical Skin
TURB – Transurethral Resection of the Infecton
Bladder DMF – Distal Mucoid Fistula
TURP – Transurethral Resection of the RGP – RetroGrade Pyelography
Prostate PPUD – Perforated Peptic Ulcer
ECCE – Extracapsular Cataract Disease
Extraction TIVA – Total Intravenous Anaesthesia
PCIOL – Posterior Chamber Intraocular GALMA – General Anesthesia
Lens Laryngeal Mask Airway
PSARPT – Posterior Sagittal Anorectal LMA – Laryngeal Mask Airway
Pull Through CHSF – Compression Hip Screw
URS – Uteroscopy Fixation
SBE – Stone Basket Extraction APR – Abdominoperineal Resection
BOO – Bladder Outlet Obstruction R – right
IOC – Intra Operative Cholangiogram L – left
POA – Post- Operative Adhesions S/P – status post
CLEA – Continuous Lumbar Epidural T/C – to consider
Anesthesia LSCS – Low Segment Caesarean
GETA – General Endotracheal Section
Anesthesia BTL – Bilateral Tubal Ligation
PHRA – Partial Hip Replacement “E” – Emergency
Arthroplasty EL – Explore Laparotomy
RMMA – Poly Methyl Metacrylic Acid PUFT -
FESS – Functional Endoscopic Sinus TAHBSO – Total Abdominal
Surgery Hysterectomy Bilateral Salphingo
SAB – Subarachnoid Block Oophorectomy
APR – Abdomino Perineal Resection PEA – Polypectomy, Ethmoidectomy,
CRD – Chronic Renal Disease Arthotomy
TUI – Transurethral Incision CGO – Complete Gut Obstruction
UVJ – Uretero – Vesicle Junction PGO – Partial Gut Obstruction
PL – Peritoneal Lavage AKA – Above the Knee Amputation
PFC – Perineal Fluid Cytology BKA – Below the Knee Amputation
PO – Partial Omentectomy CBDE – Common Bile Duct Exploration
BLND – Bilateral Lymph Node IOC – Intra-Operative Cholangiogram
Dissection MPI – Multiple Physical Injury
TBW – Tension Band Wiring BPA – Benign Prostatic Hypertrophy
ICBC – Iliac Crest Bone Grafting • Fascia
TBW – Tension Band Wiring • Muscle
ESWL – Extra Corporeal Shock Wave • Peritoneum
RAEF – Roger Anderson External
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
EL – Exploratory Laparotomy
By the eye:
DL – Direct Laryngoscopy
• Eye present – will require
SSSI – Superficial Surgical Skin
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
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


• Skin • Harrington retractor
• Subcutaneous • Army-navy retractor
• Deaver retractor
• Ribbon (malleable) retractor
• Richardson retractor (baby and ACCESSORY INSTRUMENTS
big) • Frazier suction tip
• Weitlaner retractor • Buie probe, groove director
• Gelpi retractor
• Balfour abdominal retractor AND CURRETAGE
• Spring wire retractor • Auvard vaginal speculum
• Vein retractor • Jackson vaginal retractor
• Mayo abdominal retractor • Schroeder-braun uterine
• Crile retractor tenaculum
• Harrington retractor • Schroeder uterine tenaculum
• Non-self-retaining retractor • Straight museux uterine
vulsellum forceps
• Goodell uterine dilator
SCISSORS • Sims uterine sound
• Thorek-Feldman scissors • Curtic tissue forcep
• Suture scissors • Bozeman uterine packing forceps
• Mayo scissors (straight, curved, • Forester sponge forcep
long) • Fletcher-Van Doren uterine polyp
• Metzenbaum scissors (long, forcep
curved, straight) • Hank uterine dilator
• Stitch scissors • Hegar uterine dilator
• Steven tenotomy scissors • Pratt uterine dilator
• Steven iris scissors • Sim sharo curette
• Corneal scissors (left and right) • Heaney uterine curette
• Wescott scissors • Thomas dull uterine curette
• • Kevorkian-Younge endocervical
• Straight Glassman noncrushing MINOR ORTHOPEDIC SURGERY
intestinal clamp INSTRUMENTS
• Bobcock clamp • Skin hooks
• Allis clamp • Senn retractor
• Kocker (ochsner) clamp • Rake (Volkmann) retractor
• Backhaus towel clamp (large and • Meyerding finger retractors with
small) blade
• Mosquito (Halsted) clamp • Inge lamina spreader
• Kelly clamp (straight and curve) • Heiss retractor
• Crile clamp (straight and curve) • Freer elevator
• Key periosteal elevator
• Brun (Spratt) curette (size 3-0)
NEEDLE HOLDERS • Mouse curette (double ended)
• Webster needle holder • 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
• 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
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