Page 1: Additional Patient Details

Patient Details

5.5. Any co-existing disease? i.e. not the condition requiring surgery, e.g. respiratory, cardiac, neurological, renal, gastrointestinal, musculoskeletal, etc…
6.6. Any recent (in the last month) previous surgical operation on the patient?

Please enter a date and time in the format 'DD/MM/YYYY HH:MM', for example 27/03/1980 15:43.

(dd/mm/yyyy hh:mm)

7.7. Any pre-existing medication (6-24 hours before induction), excluding sedation drugs, e.g. antibiotics, NSAIDs, bronchodilators, mucolytics, steroids, antiulcers, etc..

Admission Details

Dates need to be in the format 'DD/MM/YYYY', for example 27/03/1980.

(dd/mm/yyyy)

9.9. Case source. Was this case…

Pre-operative Evaluation

10.10. Please indicate whether any of these pre-operative checks were done

Other pre-operative measures

11.11. Were any intravenous fluids given before surgery?
a.11.a. Why?
b.11.b. What type?
12.12. Was all the anaesthetic equipment checked prior to the operation?
b.12.b. Were the checks performed using a checklist?