Pre-op Verification Pre- Procedure Check Radiographic Images Signed Consent Special Wristband Signed Consent Diagnostic Tests Patient Name Surgical Count Spine Marker Physician Signature Verbal Identification Laterality (Side) Radiographic Images Spine Marker Physician Signature Time- out Pre-op Verification Team Debriefing Medical Record Procedure Site Diagnostic Tests Emergency Procedure Surgical Count FREE SPACE Correct Implant Site Marking Unique Identifier Team Concurrence Special Equipment Correct Implant Pre- Procedure Check Medical Record Special Equipment Emergency Procedure Team Debriefing DNR Status Patient Name Consent Form Time- out Unique Identifier Laterality (Side) 2nd Time Out Consent Form Procedure Site Special Wristband DNR Status Site Marking Verbal Identification Pre-op Verification Pre- Procedure Check Radiographic Images Signed Consent Special Wristband Signed Consent Diagnostic Tests Patient Name Surgical Count Spine Marker Physician Signature Verbal Identification Laterality (Side) Radiographic Images Spine Marker Physician Signature Time- out Pre-op Verification Team Debriefing Medical Record Procedure Site Diagnostic Tests Emergency Procedure Surgical Count FREE SPACE Correct Implant Site Marking Unique Identifier Team Concurrence Special Equipment Correct Implant Pre- Procedure Check Medical Record Special Equipment Emergency Procedure Team Debriefing DNR Status Patient Name Consent Form Time- out Unique Identifier Laterality (Side) 2nd Time Out Consent Form Procedure Site Special Wristband DNR Status Site Marking Verbal Identification
(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.
Pre-op Verification
Pre-Procedure Check
Radiographic Images
Signed Consent
Special Wristband
Signed Consent
Diagnostic Tests
Patient Name
Surgical Count
Spine Marker
Physician Signature
Verbal Identification
Laterality (Side)
Radiographic Images
Spine Marker
Physician Signature
Time-out
Pre-op Verification
Team Debriefing
Medical Record
Procedure Site
Diagnostic Tests
Emergency Procedure
Surgical Count
FREE SPACE
Correct Implant
Site Marking
Unique Identifier
Team Concurrence
Special Equipment
Correct Implant
Pre-Procedure Check
Medical Record
Special Equipment
Emergency Procedure
Team Debriefing
DNR Status
Patient Name
Consent Form
Time-out
Unique Identifier
Laterality (Side)
2nd Time Out
Consent Form
Procedure Site
Special Wristband
DNR Status
Site Marking
Verbal Identification