Combined Checklist

Medications Checklist

  • Local: 0.25% Marcaine with epi (20 mL per level)
  • Irrigation:
    • 3L NaCl bag
    • 2-3 bags per level
  • Depomedrol: 40mg per level
  • Contrast: One mixture per level
    • 2cc of 0.5% methyl blue (Provay 5mg/mL) + 9cc omnipaque 300mgl/mL

RN Setup Checklist

  • C-arm on opposite side (before opening)
  • Bed
    • Jackson table with Wilson frame
    • Foam arm pads x2
    • Pillows x4
    • Prone View facemask
  • Prep stand
    • Wilson crank
    • Shaver with blade
    • Adhesive prep mitts x2
    • Isopropyl alcohol
    • 4x4 sponges
    • 1010 sticky drape x4
    • Chloraprep x2
    • Upper body air warmer
  • 2 white towels for armpits
  • SCDs
  • +/- Foley catheter
  • 6 steps