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  • Name Remarks: Name of Patient: Age: Sex: Prepared by (Circulating Nurse)

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    Mazy Jennifer Gonzales
    9 views3 pages
    The document is a surgical checklist that records information about a patient's operation including their name, age, sex, type of operation, time started and ended. It also includes an inventory of surgical instruments, sponges, needles and other supplies used during the operation with spaces to record counts at various times to ensure nothing is left inside the patient.

    Original Description:

    counting or

    Original Title

    Counting Form

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    The document is a surgical checklist that records information about a patient's operation including their name, age, sex, type of operation, time started and ended. It also includes an inventory of surgical instruments, sponges, needles and other supplies used during the operation with spaces to record counts at various times to ensure nothing is left inside the patient.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    9 views3 pages

    Name Remarks: Name of Patient: Age: Sex: Prepared by (Circulating Nurse)

    Uploaded by

    Mazy Jennifer Gonzales
    The document is a surgical checklist that records information about a patient's operation including their name, age, sex, type of operation, time started and ended. It also includes an inventory of surgical instruments, sponges, needles and other supplies used during the operation with spaces to record counts at various times to ensure nothing is left inside the patient.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    Name of patient:

    Age:
    Sex:
    Type of Operation:
    Time Started:
    Time Ended:

    NAME

    SPONGES
    OPERATING SPONGE
    ABDOMINAL PACK
    LONG PACK
    CHERRY BALLS
    PEANUT

    INSTRUMENTS
    CLAMPS
    ALLIS
    NEEDLE HOLDER
    BOB-COCK
    MIXTERS
    OCHSNERS
    TISSUE FORCEP
    THUMB FORCEP
    LONG THUMB FORCEP
    ADSON FORCEP
    DEBAKEY
    HEANEYS
    TOWEL CLIPS

    RETRACTORS
    ARMY NAVY
    RICHARDSON
    SELF RETAINING
    DEAVER

    SHARPS
    METZENBAUM
    MAYO SCISSOR
    BANDAGE SCISSOR
    KNIFE

    NEEDLES
    ATRAUMATIC NEEDLES
    FREE NEEDLES

    OTHERS

    Prepared by(Circulating Nurse):

    Confirmed by(Scrub Nurse):


    Type of Anesthesia:

    INITIAL
    COUNTI
    NG

    ADDITIO
    NS

    TIM
    E

    Approved by(surgeon):

    DEDUCTI
    ONS

    TIM
    E

    1ST
    COUNTI
    NG

    2ND
    COUNTI
    NG

    3RD
    COUNTI
    NG

    REMARKS

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