Evaluating the Patient
Once a patient is registered they will be taken to an area where they will be prepared for surgery. This is also known as Pre Surgical Preparation. The area has many names such as pre-op or surgicare. This area in the hospital or surgicenter is run by a team of nurses whose sole purpose is to prepare the patient for surgery.
Once they identify the patient and confirm the diagnosis and procedure they will begin their task. They will obtain your weight which is important for the anesthesiologist who will dose your medications based on your weight. Knowing your weight will determine if you are at risk due to obesity. Early on they will obtain your vital signs, in other words your pulse rate, respiratory rate and blood pressure.
You will be taken to a room where you will disrobe and put on a gown with a long slit in the back. It is highly functional for the medical staff but it can be uncomfortable and even embarrassing for the patient if you decide to walk to the bathroom.
Operating Room Charge Nurse
The nurse in charge of your case will meet with you and begin your pre surgical preparation. They will first review some of the specifics of your case. They will want to verify your diagnosis, surgery, allergies, recent history and history especially any surgeries that may have been ordered. This is not as detailed as the history from the pre-operative evaluation but tends to focus on the surgical procedures. Patients often wonder why these histories are so repetitive. Hopefully as more centers use an electronic medical record it will be easy for care givers to retrieve the data and not have to repeat the same process.
Patient Identification and Verification
As you prepare for surgery the care team confirms:
- The patient’s full name and date of birth
- The planned procedure
- Surgical site and laterality (if applicable)
- Allergies (medications, latex, foods, adhesives)
- Consent forms
- Updated medical and medication history
Pre Surgical Preparation
As nurses and anesthesia providers prepare for surgery they will complete the following:
- Vital signs (blood pressure, pulse, oxygen saturation, temperature)
- Review of lab results (if required)
- Airway assessment for anesthesia
- Blood sugar check for diabetic patients
- Pregnancy test when applicable
- Confirmation of NPO (nothing by mouth) status
These assessments help determine that it is safe to move forward with surgery.
Medication Review and Administration
As part of the pre surgical preparation, the team verifies which medications were taken at home and administers:
- Pre‑operative medications (e.g., antibiotics, anti‑nausea medication)
- Held medications (such as blood thinners) are reviewed to ensure compliance
- Allergy‑specific precautions, such as alternative antibiotics
Medication management reduces the risk of complications during anesthesia.
Skin Care
Reducing infection risks is a key part of pre surgical preparation and requires adequate care of the skin.
At Home
- Showering with antiseptic soap (e.g., chlorhexidine) the night before and/or morning of surgery
- Avoiding lotions, deodorant, perfumes, or powders
At the Facility
- Surgical site cleansing using an approved antiseptic solution
- Hair clipping around the surgical area if necessary (never shaving with a razor, which increases infection risk)
IV Access and Hydration
As part of pre susrgical preparation a nurse or anesthesia provider will:
- Insert an IV line
- Begin hydration fluids
- Prepare lines for medications and anesthesia
IV access ensures the team can administer anesthesia drugs quickly and safely.
Prepare for Surgery with Safety Checklists
Before the patient enters the operating room, the team performs a “time‑out” verification, which includes:
- Correct patient
- Correct procedure
- Correct surgical site
- Availability of necessary equipment
- Identification of special concerns (sleep apnea, implants, cardiac conditions, etc.)
This is an essential safety step used in all accredited surgical facilities.
Positioning, Comfort, and Anxiety Support
The team ensures the patient is:
- Warm and positioned safely on the stretcher
- Given blankets or warming devices to maintain body temperature
- Provided emotional reassurance
If the patient is anxious, the anesthesia provider may offer mild sedation.
Transport to the Operating Room
Having Enough Staff to Help: If you are awake and able to move, two staff members will usually help move safely. If you are unable to move or are unconscious, four staff members will assist you, using a transfer board or special sheet to help move you safely.
Protecting Your Airway: If you need help breathing or your airway needs special attention, an anesthesia care provider will stay at your head during the transfer to monitor and protect your breathing.
Keeping the Equipment Safe: Before moving you, the hospital staff lock the wheels on both the stretcher and the operating room table to keep them from moving.
The anesthesia team performs final checks before initiating anesthesia.
Why Proper Preparation Matters
Effective pre‑surgical preparation:
- Improves patient safety
- Lowers the risk of infection
- Reduces anesthesia complications
- Minimizes delays and errors
- Helps patients feel more confident and informed
Family and Friends
During all this time in the pre-op area it is likely you will have access to your family or significant other. This can be nice for support and to answer all those questions that might be difficult. Unfortunately, a great number of friends in your room can be disruptive to the professionals preparing your case. You want your care team to do their best. Having too many people in the room can lead to distractions. You don’t want key preparations forgotten because of these occurrences. Try to limit the number of your acquaintances in your room if possible.
