SURGICAL SAFETY AT THE LONDON VETERINARY CLINIC

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02/01/2012
SURGICAL SAFETY: At the London Veterinary Clinic we have modified a verbal checklist developed by The World Health Organisation and use it at the time of surgery as an additional safety check. The theatre nurse is responsible for the checklist although the operating vet usually asks questions or make statements. We have a crib sheet posted to remind us to ask these questions. They usually take no more than two minutes.

The checklist starts before anaesthesia and includes an identity check:
This is… eg Lucca Bean Fogle.
Lucca is here for…. eg removal of a fractured tooth.”
Signed consent?
 
More specific questions follow, including:
Surgical site identified? (This is especially important for multiple skin masses.)
Any known allergies?
Any risk of aspiration?
What blood loss is expected?
Positioning aids present?

X-rays displayed?

When special equipment such as suction is needed, the surgeon asks if these are in place.
 
A few more general questions follow:
Anaesthetic machine ready?

Monitors on?
When were premeds given?
IV in place?
How long will surgery take?
Any concerns?
 
After anaesthesia is induced but before surgery begins we verbally ask several more questions.
Sterility of instruments confirmed?
Monitors functioning?

Antibiotics (if used) given within the last 60 minutes?
Patient warming in place?
Surgical site prepared?

After surgery and before we leave the operating room we conclude with a few final spoken questions.
Instruments, swabs, sharps counted?
Specimens labelled?
Any equipment concerns?
Any recovery concerns?
Who is the recovery nurse?
Post-op plans?
Expected discharge time?
Who rings the owners?


There are always risks with any procedures but by using this verbal checklist we hope to reduce the already small risk of human error.

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