Free Surgery Equipment Checklist Template
Surgery Equipment Checklist
Prepared By: [YOUR NAME]
Prepared On: February 15, 2050
Section 1: General Preparation
-
Sterilization unit is operational.
-
OR lighting systems are functional and cleaned.
-
Waste disposal system is checked and emptied.
-
Anesthetic equipment is calibrated and stocked.
Section 2: Surgical Instruments
|
Instrument Name |
Quantity |
Condition |
Last Maintenance Check |
|---|---|---|---|
|
Scalpels |
10 |
Sterile |
January 20, 2050 |
|
Forceps |
15 |
Sterile |
January 15, 2050 |
|
Sutures |
20 packs |
Sterile |
February 1, 2050 |
|
Surgical scissors |
5 pairs |
Good Condition |
February 10, 2050 |
Section 3: Emergency Readiness
-
Defibrillator is operational and charged.
-
Backup power supply tested.
-
Blood supply matches patient type requirements.
-
Emergency crash cart is stocked and accessible.
Section 4: Documentation and Contacts
|
Task |
Responsible Person |
Contact Details |
|---|---|---|
|
Checklist Approval |
[YOUR NAME] |
[YOUR EMAIL] |
|
Equipment Supplier Contact |
Vendor Rep. |
maxwell@you.mail |
|
Maintenance Follow-Up |
Tech Support Lead |
orval@you.mail |
For inquiries or updates, contact [YOUR COMPANY EMAIL] or call [YOUR COMPANY NUMBER]. Keep this checklist updated regularly to maintain the highest surgical standards and patient safety!
