Adult Cardiac Surgery Checklist
From the The Society of Thoracic Surgeons
Sign In
1. 1 - Before Induction - Sign In
Has the patient confirmed: -Identity -Site -Procedure -Consent
2. 2 - Before Induction - Sign In
Is the site marked?
Details:
Yes / Not applicable
3. 3 - Before Induction - Sign In
Is the anesthesia safety check complete?
4. 4 - Before Induction - Sign In
Is the pulse oximeter on patient? Is it functioning?
5. 5 - Before Induction - Sign In
Check UNOS ID# (if applicable)
6. 6 - Before Induction - Sign In
Does the patient have a known allergy?
Details:
Yes / Not applicable If yes, is it drug, latex or other?
7. 7 - Before Induction - Sign In
Is there a difficult airway / an aspiration risk?
Details:
No / Yes, and equipment/assistance available
8. 8 - Before Induction - Sign In
Does the patient have a risk of >500ml blood loss (7ml/kg in children)?
Details:
No / Yes, and adequate intravenous access and fluids planned
9. 9 - Before Induction - Sign In
Is there blood available?
Time Out
1. 1 - Before Skin Incision - Time Out
Confirm all team members have introduced themselves by name and role.
2. 2 - Before Skin Incision - Time Out
The surgeon, anesthesia professional and nurse must verbally confirm: -Procedure -Perfusion Temp -Prep Protocol -Site/Side -Position -Blood Born Path Implants and Equipment
3. 3 - Before Skin Incision - Time Out
Surgeon must review -Critical or Unexpected Steps, Airway or Ventilatory Issues -Operative Duration, anticipated blood loss. -Fluid Management
4. 4 - Before Skin Incision - Time Out
Anesthesia Team Reviews: Any patient specific concerns?
5. 5 - Before Skin Incision - Time Out
Nursing Team Reviews: -Has sterility (including indicator results) been confirmed? -Are there equipment issues or any concerns?
6. 6 - Before Skin Incision - Time Out
Has antibiotic prophylaxis been given within the last 60 minutes?
Details:
Yes / Not applicable
7. 7 - Before Skin Incision - Time Out
DVT prophylaxis?
Details:
-Compression stockings -SQ Hepari
8. 8 - Before Skin Incision - Time Out
Is essential imaging displayed?
Details:
Yes / Not applicable
Sign Out
1. 1 - Before Patient Leaves Room - Sign Out
Nurse must verbally confirm with the team: -name of the procedure -that instrument, sponge and needle counts are correct or not applicable
2. 2 - Before Patient Leaves Room - Sign Out
Post Pump ABX
3. 3 - Before Patient Leaves Room - Sign Out
Medication / Drips
4. 4 - Before Patient Leaves Room - Sign Out
How the Specimen is Labelled
Details:
Including Patient Name
5. 5 - Before Patient Leaves Room - Sign Out
Whether there are any equipment problems to be addressed
6. 6 - Before Patient Leaves Room - Sign Out
Surgeon, anesthesia professional and nurse must review the key concerns for recovery and management of this patient