Session 4 - Review

Question 1

List the six standard surgical chart forms in order from pre to post-op.

Answer 1

1. Surgical Consent Form
2. Pre-Op Checklist / OR Check Off List
3. Anesthetic Record
4. Surgical Count Sheet / OR Count Sheet
5. Operation Report / Operating Room Record
6. Post-Anesthetic Recovery Room Record

Question 2

What is an OR Slate and give 6 points of information contained on it.

Answer 2

The OR Slate is sent to the units M-F for patients on that unit that are scheduled for surgical procedures the next day.

It includes info such as:

• Patient’s name
• Patient’s age
• Time of surgery
• Diagnosis
• Surgical procedure being performed
• Name of surgeon performing procedure
• Name of anesthetist
• Family GP
• Allergies
• Any pertinent information/requests related to the procedure (ex. x-ray in PAR, special instruments requested by the surgeon)