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The Checklists

The Checklists. Dr. Sanjay Gupte MD, DGO, FICOG, FRCOG President FOGSI 2010 National Convener "Save the Mother & Newborn National Initiative" Secretary General World Gestosis Organization Member Central Supervisory Board of PCPNDT Act Member Ethics Committee, Medical Council India

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The Checklists

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  1. The Checklists Dr. Sanjay Gupte MD, DGO, FICOG, FRCOG President FOGSI 2010National Convener "Save the Mother & Newborn National Initiative" Secretary General World Gestosis Organization Member Central Supervisory Board of PCPNDT ActMember Ethics Committee, Medical Council India Chairman Ethics Committee of Maharashtra Medical Council

  2. Pre-anesthesia Questionnaire • Is this the 1st surgery you are undergoing? • Any previous hospitalization? • Do you use contact lenses, dentures, pacemaker? • Have you recently suffered from influenza, cold, cough, fever, sore throat? • Have you recently suffering from chest pain, cough, breathlessness, vomiting, ankle edema ? • Any medicines at present? • Any known allergies? • Any BT received in the past? • Any anesthesia in the past/ any complication? • Have you suffered from heart disease/ HT/ asthma/convulsions/DM/ cancer/jaundice? DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  3. Pre op check list : do & confirm • Name, diagnosis, procedure • Pre op instructions followed – NBM, medicines to be taken (inhalers, Betnesol, anti hypertensive, thyroid medicine. misoprost), medicines to be withheld (ASA, Hypoglycemics, Heparin) • Pre op investigations, imaging reports • Pre op check by Physician, anaesthetist • Consent – informed/high risk/tubal ligation/NICU/stem cell • X match & blood group – blood kept ready • Risk factors social/medical/allergies DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  4. Pre op antibiotics amoxicillin / cefotaxime / metronidazole • Usual drugs which are contraindicate NSAIDS/Scoline/Prostaglandins • Additional equipment drains, epidural catheter • Trolley check Mop/ instrument count • Baby preparation trolley/ baby label/ baby paper/ pediatrician call/ NICU call/ warmer DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  5. Pre-anesthesia information to be given by the patient

  6. Check list for anesthetist • Name, diagnosis, procedure • Pre op instructions followed – NBM, medicines to be taken (inhalers, Betnesol, anti hypertensives, thyroid medicine. misoprost), medicines to be withheld (ASA, Hypoglycemics, Heparin) • Pre op investigations, imaging reports • Preop check by Physician, anaesthetist • Consent – informed/high risk/tubal ligation/NICU/stem cell • Difficult airway/ aspiration risk • X match & blood group – blood kept ready • Premedication DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  7. Check list for anesthetist • Ambu bag • LMA • Anaesthetic drugs – Atropine/ Mephentin • Emergency drugs • Cardiac monitor/Pulse • Boyle’s/O2/Nitrous/Vapouriser • Laryngoscope with light • Bain’s circuit with mask • Endotracheal tube No 7 • Airway - Green color • GA preparedness DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  8. Post Op check list for doctors: • Sponge & instrument count check • Pulse/BP/PPH/O2 saturation • Urine output/Colour • Lab sent – HPE/cord blood • Baby – warmer/label • Anesthetist permission for shifting the patient out of the OT • Reminder to sister about any instrument review DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  9. Labour room safety starts with Antenatal counseling DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  10. Antenatal high risk tagging • B.O.H. • Treated Infertility • Previous C.S. • IUGR • Incompos • Hydramnios • RH Incompatibility • PIH • TH Abortion • Prematurity • Diabetics • Anaemia • APH / PP • PPH • Elderly Primi • Previous Abortions • Post Dalism • Previous Bl. Transfusion • Hepatitis • Thyroid Dysfn • Oligohydramnios • Short Strature • Obesity • CPD DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  11. Pre labour check-list • Detailed history considered • No contraindication to labour to proceed- pelvic assessment. • Previous scar • Myomectomy • Hysterotomy • LSCS • Allergies if any- contraindicated drugs DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  12. Blood group- whether to X match • Rh typing • Any need for modified protocol – augmentation, only short trial • Readiness & availability of staff & labour room • Inform pediatrician & anesthetists • Presence & discussion with relatives • Consent for instrumentation DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  13. Delivery check list • Pre delivery check list- SOS anesthesia • Investigations reviewed • Allergies checked – contraindicated drugs • Relatives informed- SOS informed consent • Blood X matched • Stem cells or other samples considered • Labour room equipment checked • Trolley laid out & checked • Emergency medicines available • Baby’s preparation DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  14. Post delivery check list • Patient’s condition • Uterus palpation – PPH checked • Episiotomy wound checked • Baby’s condition & cord • Baby labeled & breast fed DR. SANJAY GUPTE, MD DGO FICOG FRCOG

  15. DR. SANJAY GUPTE, MD DGO FICOG FRCOG

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