The Checklists

Dr. Sanjay GupteMD, DGO, FICOG, FRCOG

President FOGSI 2010National Convener "Save the Mother & Newborn National Initiative"

Secretary General World Gestosis OrganizationMember Central Supervisory Board of PCPNDT ActMember Ethics Committee, Medical Council India

Chairman Ethics Committee of Maharashtra Medical Council

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

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

– 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

Pre-anesthesia information to be

given by the patient

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

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

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

Labour room safety starts with Antenatal counseling

DR. SANJAY GUPTE, MD DGO FICOG FRCOG

Antenatal high risk tagging • B.O.H.• Treated Infertility• Previous C.S.• IUGR• Incomp os• 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

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

• 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

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

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

DR. SANJAY GUPTE, MD DGO FICOG FRCOG