Procedure Checklists

Universal Preprocedure Checklist

Before Patient Arrival

Confirm order, indication, and urgency.
Verify required equipment, contrast, and disposables are available.
Check room readiness and infection control supplies.

On Patient Arrival

Confirm patient identity (two identifiers) and procedure site.
Review allergies, renal function, pregnancy status, and medications.
Obtain and document informed consent when required.
Explain procedure, expected sensations, and postprocedure instructions.

Time Out

Team pause immediately before starting: confirm patient, procedure, side, and key risks.
Confirm availability of emergency drugs and resuscitation equipment.

Contrast Administration Checklist

Screening

Confirm contrast type and indication (iodinated, gadolinium, oral, rectal).
Check recent creatinine/eGFR per institutional threshold.
Review prior contrast reactions and premedication status.

Preparation

Verify IV access size and patency; select appropriate catheter for injector.
Program injector: agent, volume, rate, and pressure limits; confirm with second staff member when possible.
Document lot number, expiration, and volume to be administered.

During Injection

Monitor patient for pain, swelling, or allergic symptoms; stop immediately if extravasation suspected.
Record actual volume administered and any deviations from protocol.

Post Injection

Provide postcontrast hydration instructions if indicated.
Document contrast details in report and patient chart.

Sedation And Anesthesia Checklist

Pre Sedation

Confirm fasting status and consent for sedation/anesthesia.
Review airway history, ASA status, and allergies.
Ensure monitoring equipment (pulse ox, BP, ECG) and reversal agents are available.

During Sedation

Continuous monitoring by trained personnel; document vitals at regular intervals.
Maintain airway readiness and oxygen supplementation as needed.

Recovery

Use standardized discharge criteria (airway, vitals, orientation) before release.
Provide written post sedation instructions and emergency contact details.

Interventional Radiology And Biopsy Checklist

Preprocedure

Confirm imaging review, target location, and approach; mark site if applicable.
Check coagulation status and platelet count; follow hold/bridge anticoagulation policy.
Confirm informed consent and discuss potential complications (bleeding, infection, pneumothorax).

Intraprocedure

Maintain sterile field; use ultrasound/CT guidance as planned.
Document needle type, number of passes, and sample adequacy.
Monitor patient hemodynamics and comfort continuously.

Postprocedure

Apply appropriate dressing and compression; monitor for bleeding and neurovascular status.
Provide clear postprocedure instructions including activity restrictions and signs of complications.

Mammography And Breast Procedures Checklist

Screening/Diagnostic Mammography

Confirm prior imaging availability and comparison studies.
Remove deodorant/powder; explain compression and views required.

Image Guided Biopsy/Localization

Verify lesion location and marker availability; confirm pathology requisition.
Document marker placement and obtain postprocedure mammographic confirmation images.

MRI Procedure Checklist

Screening

Complete MR safety questionnaire for implants, devices, and ferromagnetic risk.
Confirm contrast indication and renal function if gadolinium planned.

During Exam

Provide ear protection and communication device; monitor for claustrophobia.
Ensure proper coil selection and positioning for optimal SNR.

Ultrasound And Vascular Access Checklist

Before Procedure

Confirm indication and target vessel/organ; select appropriate probe and sterile cover.
Prepare local anesthetic and sterile tray for biopsies or line placement.

During Procedure

Use real time guidance; visualize needle tip at all times when possible.
Document approach, catheter size, and final tip position.

Postprocedure And Discharge Checklist

Immediate Postprocedure

Monitor vitals and site for bleeding or complications for appropriate observation period.
Confirm specimen labeling and transport for pathology when applicable.

Discharge Instructions

Provide written and verbal instructions including activity limits, wound care, and emergency signs.
Document follow up plan and contact information for urgent concerns.

Emergency And Escalation Checklist

Immediate Response

If anaphylaxis or severe reaction occurs: stop procedure, call for help, administer emergency meds per protocol, and activate resuscitation team.
For major bleeding or compartment syndrome: apply pressure, stabilize limb, notify surgical/IR team immediately.

Reporting And Follow Up

Document incident, notify RSO or risk management as required, and schedule follow up imaging or clinical review.

Implementation Tips

Practical Notes

Keep laminated checklists in procedure rooms and integrate into electronic workflows where possible.
Train staff with simulation drills and review checklists during morbidity and safety meetings.
Customize checklists to local policies, equipment, and regulatory requirements.