Operating theatre equipment checklist: the pre-list safety check, step by step

Operating theatre equipment checklist: who checks, when and how

A theatre equipment check before surgery is normally done at the start of the day by the circulating nurse, with biomedical support for technical checks, and repeated at the start of each list and whenever a device is changed. The aim is a quick functional check, not a service. Record the date, the room, the items checked, any defect and who was told.

Use a laminated list in the room and a signed log. Tag any device that fails as out of service and report it to biomedical engineering. Never plan to fix a fault during a case if a standby is available. Link the log to your wider asset management, as covered in operating theatre equipment management.

Operating table and surgical lights

Check the table cleanliness, mattress integrity and the power or battery status. Run the main motions: height, tilt, Trendelenburg and reverse, back and leg section movements. Confirm that the brakes or floor lock hold, that the hand control and the back-up panel respond and that memory positions return correctly. Inspect the rails, side clamps and arm boards, and make sure the safe working load matches the patient.

Look for hydraulic leaks, unusual noises or slow motion. If your table is a modular electric model such as the Lojer Scandia Prime, which has a battery-powered operation, a hand control and a backup panel on the column, check the charge level and the response of both control points before the first case.

Switch on each light head and confirm that all LEDs work, that the light field is even and that dimming works. Move the arms through their range and check they hold position without drifting. Test any camera, handle and sterile cover fixtures. Replace or report damaged handles and cover seals, and check the emergency lighting or backup supply if it is part of your system.

Electrosurgical unit

Check the power cord and plug, the foot switch and the patient plate lead. Carry out the generator's self-test and confirm that the displays and acoustic signals work. Check that the correct neutral electrode is available and that neutral-electrode monitoring is active. For example, the BOWA ARC 350 provides continuous self-testing and neutral-electrode monitoring, so a self-test fault or an electrode alarm should be taken seriously.

Inspect the handpieces and cables for cracks in the insulation and bent pins. Set the cutting and coagulation settings according to the surgeon's preference, and keep a spare unit available. See the BOWA ARC 350 page for its features.

Suction, medical gases and alarms

Fit a clean canister, check the tubing and connectors, and open the regulator to test vacuum build-up. Confirm the gauge reads correctly when the line is occluded and that the bacterial filter is in place and dry. A unit like the ATMOS Record 55 has two diaphragm pumps, an adjustable vacuum with a visible gauge, a hydrophobic bacterial and viral filter and a maximum vacuum of −98 kPa; always check against the unit's own manual. See ATMOS Record 55.

Prepare a second suction source, since a failing suction system during a case is a common cause of delay.

Check the wall or pendant outlets for oxygen, medical air and suction, and test that the connectors seat correctly and hold. Look at the gas alarm panel: it should show normal pressure and no active alarms. Area monitoring units such as the MZ Liberec MZU II give light and acoustic alarms for pressure, flow or supply problems; read the display and confirm there are no fault indications. See MZ Liberec MZU II.

Report any hissing, leaking or loose outlet at once and do not use it. Keep reserve cylinders with regulators available.

Final checks and escalation

If something fails, escalate based on risk: patient-connected and life-support devices are priority. Use the same list for the pre-list briefing. For planning the room equipment, see the operation theatre equipment list, and for support from specialists, contact Beckfinity.

• Monitors and anaesthesia machine on, with alarms audible.
• Tourniquet, warmer and diathermy accessories present.
• Emergency equipment: defibrillator, airway, spare light.
• Sterile sets and containers inspected and in date.