Procedure Site Diagnostic Tests Unique Identifier Special Wristband Consent Form Correct Implant Medical Record Signed Consent Pre-op Verification Special Equipment Radiographic Images Patient Name Pre- Procedure Check Signed Consent Pre-op Verification Consent Form Medical Record FREE SPACE Special Wristband Spine Marker Team Debriefing Time- out Spine Marker Surgical Count Laterality (Side) Diagnostic Tests Emergency Procedure 2nd Time Out Emergency Procedure Physician Signature Time- out DNR Status Team Concurrence Verbal Identification Team Debriefing Laterality (Side) Special Equipment Patient Name Correct Implant Physician Signature Site Marking Surgical Count Unique Identifier Procedure Site Site Marking DNR Status Pre- Procedure Check Verbal Identification Radiographic Images Procedure Site Diagnostic Tests Unique Identifier Special Wristband Consent Form Correct Implant Medical Record Signed Consent Pre-op Verification Special Equipment Radiographic Images Patient Name Pre- Procedure Check Signed Consent Pre-op Verification Consent Form Medical Record FREE SPACE Special Wristband Spine Marker Team Debriefing Time- out Spine Marker Surgical Count Laterality (Side) Diagnostic Tests Emergency Procedure 2nd Time Out Emergency Procedure Physician Signature Time- out DNR Status Team Concurrence Verbal Identification Team Debriefing Laterality (Side) Special Equipment Patient Name Correct Implant Physician Signature Site Marking Surgical Count Unique Identifier Procedure Site Site Marking DNR Status Pre- Procedure Check Verbal Identification Radiographic Images
(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.
Procedure Site
Diagnostic Tests
Unique Identifier
Special Wristband
Consent Form
Correct Implant
Medical Record
Signed Consent
Pre-op Verification
Special Equipment
Radiographic Images
Patient Name
Pre-Procedure Check
Signed Consent
Pre-op Verification
Consent Form
Medical Record
FREE SPACE
Special Wristband
Spine Marker
Team Debriefing
Time-out
Spine Marker
Surgical Count
Laterality (Side)
Diagnostic Tests
Emergency Procedure
2nd Time Out
Emergency Procedure
Physician Signature
Time-out
DNR Status
Team Concurrence
Verbal Identification
Team Debriefing
Laterality (Side)
Special Equipment
Patient Name
Correct Implant
Physician Signature
Site Marking
Surgical Count
Unique Identifier
Procedure Site
Site Marking
DNR Status
Pre-Procedure Check
Verbal Identification
Radiographic Images