Surgery Day Checklist | Dr. Albert Lynch

The day before surgery:

Call the owner to confirm the planned surgery, surgical limb and drop off time at your hospital in the morning.

Confirm that the pet must be fasted (no food allowed) after 10pm, but that water is ALWAYS ALLOWED

Owner has been guided to review their Surgery Day Expectations and has been directed to read Resources in Pet Owner Resources to prepare themselves and their pet for surgery.

Only if prescribed and advised by the attending veterinarian – Confirm that the pet should get their gabapentin and trazodone the evening prior and the morning of surgery. This may be given with a very SMALL amount of food o NSAID medication may be given with food the evening prior to surgery, but should be skipped the morning of surgery

Confirm that you have appropriate supplemental staffing for the day of surgery (two anesthesia trained nurses) and that the operating room is clean

For each patient, print an anesthesia sheet with the requested anesthetic medication, emergency/crash medications and intravenous antibiotics, along with dosages (not volumes), as directed by the attending veterinarian.

With the owner present at the time of drop-off:

Confirm that this is the legal owner of the patient and is of age (at least 18 years old)

Confirm that this is the correct patient and that they match your patient chart

Confirm that the patient has been fasted appropriately, the last time of any medications that were given, what those medications were and if there are any known allergies

Confirm that the owner has no additional medical or surgical concerns with their pet and that there has been no coughing/vomiting/diarrhea in the last 72 hours

Confirm that your hospital has the appropriate financial deposit

Confirm that the procedure on the consent form is the procedure that the owner is dropping their pet off to have performed

Confirm that the surgical limb on the consent form is the limb that the owner is anticipating their pet to have surgery on – HAVE THEM DIRECTLY TOUCH THE LIMB. You may even ask them to mark the limb with a marker or shave a small patch of fur with clippers.

Confirm that the consent form has been signed by the legal owner

Confirm that the consent form has been signed by yourself or another authorized hospital representative

Once the patient has been admitted to the hospital:

Immediately label/identify the patient with a neck band or equivalent

Immediately shave a small patch of fur on the surgical limb, which the owner has just physically confirmed. This does not need to be done if your hospital practice it to have the owner perform this at the time of drop off.

Weigh the patient and begin calculating medication volumes (the dosages and requested drugs should be on the anesthetic sheet prepared the evening prior). This includes anesthetic medication, emergency/crash medications and intravenous antibiotics. Have at least one additional qualified staff member check these calculations, then draw them up.

Place intravenous catheter in a limb that is not the surgery limb. Check the patency of this catheter, then protect the catheter by placing an E-collar on the patient and begin intravenous fluids as directed by your attending veterinarian

Check the patient’s blood glucose, record the value and notify the attending veterinarian

Confirm that pre-operative bloodwork has been performed and that this has been reviewed by the attending veterinarian and stated to be normal

Confirm that pre-operative imaging studies have been performed and reviewed by the attending veterinarian or board-certified radiologist

Check equipment and operating room – Leak check the anesthetic machine and circuit, ensure adequate oxygen supplies, ensure that the inhalant anesthetic volume is full, ensure that monitoring equipment is functioning appropriately

Check to make sure that X-ray machine is on and that patient information is ready in system for radiographs pre-operatively and post-operatively

Intra-operative checklist – Surgical and anesthetic differences:

Appropriate personnel – One well-trained anesthetic nurse present at all times while patient undergoing induction and throughout the patient’s anesthetic episode. One ADDITIONAL nurse to assist with induction until patient is prepped in the operating room, as well as to monitor the patient during their post-anesthetic recovery

Peri-operative antibiotics (e.g. Cefazolin 22mg/kg I/V) should be given under anesthesia during patient preparation AND every 90 minutes after that until skin closure has occurred

Pre-medication should include a full-mu opioid analgesic (e.g. methadone or hydromorphone)

Post-operative discharge:

Assess patient comfort and give opioid analgesia if indicated (ask attending veterinarian)

Ensure that patient is fully recovered from their general anesthetic and is normothermic

When speaking to owner, confirm the procedure that was performed and that their pet has recovered appropriately. Go through their discharge instructions with them and confirm their next appointment time and date (for suture removal)

Confirm with the owner the next time their pet is due for medication (generally the next morning, unless patient is eating well and the owners wish to begin medication that evening)

One day AFTER surgery:

Call owner to check in on progress at home and see if they have any questions that you can answer or that can be answered in their surgery day expectations and home recovery program booklet

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