CARDIAC OT POCKET CHECKLIST

Efficient. Sterile. Life-Saving.

Inspired by Dr. Dhiren Shah’s surgical standards

BEFORE PATIENT ENTERS OT

• Review patient consent, surgical plan, and history

• Verify blood availability, valve/graft type (if applicable)

• Check functionality:

  • OT lights, cautery, suction

  • ECG monitor, defibrillator

  • Perfusion system (if bypass involved)

• Ensure sterile trays & instruments are ready:

  • Sternotomy set

  • Valve/graft/prosthesis trays

  • Extra sutures, blades, gauze

• Count instruments, sharps, and swabs (document start count)

• Confirm patient ID, surgical site, and allergies with team

IMMEDIATELY BEFORE INCISION

• Time-out performed: confirm correct patient, site, and procedure

• Skin prep and draping completed

• Antibiotics administered

• Cardiopulmonary bypass setup verified (if needed)

• Pacing wires, cannulas, and clamps kept ready

INTRAOPERATIVE: STAY PROACTIVE

• Anticipate next steps – hand over before being asked

• Monitor suction and field visibility

• Keep suture materials organized and counted

• Communicate clearly, concisely, and respectfully

• Reinforce sterile barrier – correct breaches immediately

• Record clamp time, bypass time, and heparin administration accurately

POST-PROCEDURE CHECKLIST

• Final count of instruments, gauze, and sharps

• Label and send any specimens collected

• Document implant details (size, type, serial number)

• Assist with drain placement and wound dressing

• Remove drapes carefully and apply final dressings

• Handover to ICU nurse/doctor with brief clinical summary

• Clean, sterilize, and restock instruments

• Reorder any special items used during the case

EMERGENCY PREPAREDNESS

• Crash cart stocked and accessible

• Emergency sternal saw, vascular clamps, pacing wires ready

• Defibrillator charged and functional

• Backup suction and oxygen connections available

BEHAVIOUR & HYGIENE STANDARDS

• Maintain silence and surgical focus inside OT

• No casual talk, jokes, or mobile use

• Use double gloves when appropriate

• Follow strict hand hygiene between tasks

• Maintain patient dignity and respect at all times

CORE PRINCIPLES

• Be Alert

• Anticipate the Surgeon’s Needs

• Assist Actively

• Maintain Accountability

• Act Respectfully at All Times