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