Peds Spine Resident Checklist Prior to Incision Last Updated 1517 Preop Postincision PreInstrumentation After Instrumentation Preop xrays including bending films ID: 763174
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Peds Spine Resident Checklist Prior to Incision Last Updated: 1.5.17 Pre-op Post-incision / Pre-Instrumentation After Instrumentation Pre-op x-rays including bending filmsLabel images including rib / vertebral body counting - Check for anatomic variants (if present, refer to counting strategy below*)Patient had CHG skin wash before surgeryAIS Patients:Patient received Neurontin High Risk Patients:Peri-op UA + urine culture completedProcalcitonin levels IV Cefazolin + Tobramycin delivered 15-60 min prior to incisionSubstitute Vancomycin for Cefazolin if patient Beta-lactam allergic or colonized with MRSA Confirm Weight-based Dosing & Timing:Cef 30mg/kgTobra 2.5 mg/kg Vanc 15 mg/kgVerify image labeling with attending (if variants, re-review labeling / counting) Fluoro level confirmation with attending verification prior to placement of proximal and distal screws - Confirm / Re-dose patient with IV antibiotic prophylaxis: Cef q 4 hrsTobra q 8 hrsVanc q 8 hrs1 gm Vancomycin powder rubbed into spine muscles after the exposure AND 1gm rubbed in before instrumentation Final tightening performed on all screw caps Patient had intra-op betadine soak x 3 min Bucket Irrigation on the field contains 50,000 Units Bacitracin/500 Units Polymixin in 1L Normal SalineX-rays done to confirm screw placement Two drains placedOne superficialOne deep Name:DOB: MRN: * Post-op orders/ PICU sign out sheet reviewed with PICU team Signature________ MD Print Name_____________ ID Code_____ Date__/__/__ Time____ AM /PM 1. Start at 1 st vertebra with ribs and call that T1 2. Continue labeling vertebrae until last one with ribs is identified (e.g. T11, T12, or T13) 3. If there are 11 definite ribs with 6 vertebrae below and it is not clear if the 12 th vertebra has a rib, call it T12 to maintain 12 thoracic and 5 lumbar numbering 4. In all cases, the 1 st vertebra below the last thoracic vertebra is considered L1. 5. Review L5 junction for lumbarization or sacralization of the transitional vertebra. If L5 is sacralized , it is still necessary to measure coronal and saggital Cobbs to S1 (vs L5) and also measure the sagittal balance from C7 to S1 (vs L5)