WHO Surgical Safety Checklist incomplete

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Before induction of anaesthesia

• Patient has confirmed - identity - site - procedure - consent

• Site marked or not applicable

• Anaesthesia safety check completed

• Pulse oximeter attached and functioning

• Does the patient have a:

• Known allergy

  No

  Yes

• Difficult airway / aspiration risk?

  No

  Yes

• Equipment and assistance available.

• Risk of > 500ml blood loss (7ml/kg in children)

  No

  Yes

• Adequate intravenous access and fluid planned.

• Difficult airway or aspiration risk?

  Off

  On

• Equipment and assistance available.