====== Preoperative Checklist ====== **Patient Name:** ....................... **Date of Surgery:** ....................... **Procedure:** ....................... **Surgeon:** ....................... **Hospital ID (SIP/NHC):** ....................... ===== 1. Identification ===== * [ ] Confirmed full name and ID with patient * [ ] Correct side and site marked * [ ] Consent form signed and scanned * [ ] Allergy status documented ===== 2. Clinical Evaluation ===== * [ ] Complete medical history reviewed * [ ] Neurological exam updated (GCS, focal signs) * [ ] Seizure history evaluated (if applicable) * [ ] ASA classification assigned: ___ * [ ] Functional status recorded (e.g. Karnofsky/Rankin): ___ ===== 3. Imaging ===== * [ ] MRI reviewed * [ ] CT reviewed * [ ] Neuronavigation data uploaded (if applicable) * [ ] Vascular imaging reviewed (CTA/MRA/DSA) * [ ] Functional imaging (fMRI/DTI) evaluated (if required) ===== 4. Laboratory & Preanesthesia ===== * [ ] CBC * [ ] Coagulation profile * [ ] Electrolytes, renal function * [ ] ECG (if >40 or cardiac history) * [ ] Anesthesia evaluation completed * [ ] COVID test (if required) ===== 5. Medication & Preparation ===== * [ ] Antiepileptics continued (if indicated) * [ ] Anticoagulants/antiplatelets managed appropriately * [ ] Corticosteroids administered (if edema/mass effect) * [ ] Antibiotic prophylaxis ordered * [ ] DVT prophylaxis planned * [ ] Bowel prep (if spinal or indicated) * [ ] Blood group and crossmatch done ===== 6. Logistics ===== * [ ] ICU / HDU bed reserved * [ ] Neuronavigation system available * [ ] Microscope / endoscope / neuro-monitoring prepared * [ ] Special equipment (clip, shunt, stimulator) ready ===== 7. Patient Instructions ===== * [ ] NPO status confirmed * [ ] Preop hygiene and shaving (if needed) * [ ] Jewelry and prostheses removed * [ ] Psychological support offered ===== 8. Team Briefing (WHO Surgical Safety) ===== * [ ] Surgical team briefing completed * [ ] Surgical pause/time-out planned ===== Final Check ===== * [ ] All documentation uploaded to EHR * [ ] Checklist reviewed and signed by responsible physician **Signed by:** ...................................... **Date/Time:** ......................................