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Admission, Pre-op & Post-op Checklists

The lists that prevent missed steps at 3 a.m.

Aug 15, 2026 · 3 refs

At a glance

Checklists are how tired teams stay safe. Admission, pre-op, and post-op lists do not replace thinking — they catch the missed tetanus, the undocumented NV exam, and the DVT prophylaxis that slips when the pager will not stop.

Decision-making

Use a list when the patient crosses a care boundary: ED to floor, floor to OR, OR to floor. If a box cannot be checked, that is a clinical problem to solve — not a clerical annoyance to skip.

Technique pointers

Admission (examples)

  • Diagnosis / laterality / open vs closed
  • NV exam documented
  • Antibiotics / tetanus if open
  • Imaging adequacy; reduction / splint status
  • NPO / medical co-management needs

Pre-op

  • Consent / site marking / implants available
  • Labs, type & screen as indicated
  • Clearance issues escalated
  • Antibiotics timed

Post-op

  • NV exam after immobilization
  • Weight-bearing status written clearly
  • VTE prophylaxis plan
  • Wound / pin-site care and follow-up timing

High-yield / exam

  • Boundaries of care are where errors cluster
  • Open fracture meds are easy to miss
  • Weight-bearing status must be explicit
  • Post-op NV exam is part of the operation

Questions

On call and Boards items for this topic are coming.

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Your pearl

One line you’d tell a junior at 2am.

References

  1. 01

    WHO surgical safety checklist — principles applied to operative care handoffs

    2009 · American Academy of Orthopaedic Surgeons (guidelines / AUC) · guideline

    Checklist culture reduces omitted safety steps at care transitions.

  2. 02

    Communication and handoff quality in orthopedic trauma care

    2016 · Journal of the American Academy of Orthopaedic Surgeons · review

    Structured handoffs reduce missed injuries and delayed decisions.

  3. 03

    OTA resident teaching on admission and peri-operative trauma checklists

    2020 · Orthopaedic Trauma Association · guideline

    Practical night-float lists for open fracture meds, NV exams, and VTE planning.

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