Surgical Time-Out
THINK: Equal role and voice for all team members
SFA Emphasis: Speak up, stop the case if discrepancies exist
Trigger: Time-out effectiveness
Wrong-Site Surgery Prevention
THINK: Site marking and presurgical checklists
SFA Emphasis: Verify consent, site, procedure—don’t assume
Trigger: Wrong patient / wrong site
RSIs & Laparoscopic Conversion
THINK: RFID-tagged sponges/instruments
SFA Emphasis: Heightened count awareness during conversions
Trigger: New or evolving RSI prevention
Pressure Injury Prevention
THINK: Preoperative risk & skin assessment
SFA Emphasis: Identify risk BEFORE positioning
Trigger: Most important factor
Informed Consent Requirement (special)
THINK: Organ procurement
SFA Emphasis: Verify consent exists before incision
Trigger: Non-routine / ethical procedure
Specimen Handling Error
THINK: Misdiagnosis of patient condition
SFA Emphasis: Correct labeling, source, chain of custody
Trigger: Most serious outcome
Patient Limiting Consent
THINK: Right to informed consent
SFA Emphasis: Honor restrictions (no residents, no photos)
Trigger: Patient modifies consent
DNR & End-of-Life Care
THINK: PSDA and advance directives
SFA Emphasis: Clarify DNR status intraoperatively
Trigger: Hospice / competent patient
Antibiotic Misuse
THINK: Antibiotics for every incision regardless of indication
SFA Emphasis: More antibiotics ≠ better care
Trigger: Routine use
OR Cleaning & MDROs (multidrug-resistant organisms)
THINK: Enhanced cleaning procedures
SFA Emphasis: Advocate for terminal/enhanced cleaning
Trigger: MDRO present
Purpose of Sterile Drapes
THINK: Barrier to microorganisms, fluids, particulates
SFA Emphasis: Strike-through = contamination
Trigger: Why drapes exist
Draping Technique
THINK: Incision site first → periphery
SFA Emphasis: No repositioning once placed
Trigger: How to drape
Sliding an Obese Patient
THINK: Shear injury
SFA Emphasis: Lift—don’t slide
Trigger: Long case + movement
Repositioning During Case
THINK: Reassess alignment, tissue integrity, pressure areas
SFA Emphasis: Positioning is continuous
Trigger: After repositioning
Elbow Pressure Injury
THINK: Ulnar nerve injury
SFA Emphasis: Pad elbows, neutral arm position
Trigger: Arm boards + elbow
Lithotomy Neuropathy
THINK: Common peroneal nerve
SFA Emphasis: Protect fibular head
Trigger: Lithotomy + foot drop
Lateral Kidney Position
THINK: Kidney bridge; vena cava compression
SFA Emphasis: Balance exposure with hemodynamics
Trigger: Flank elevation
