General Hospital • Operating Theatre

OT to PACU Handover Checklist

SBAR / I-PASS Format

S Situation & Background

A Assessment (Intra-Op Course)

O2 Support:
BP:
HR:
SpO2:
Temp:
Last Analgesia:
Antiemetic given:
Reversal given:
ml
ml
ml
units
Drains:
Packs:
Dressing:

R Recommendation (Post-Operative Plan)

Handover Acceptance & Signatures

1. Sending OT Nurse

2. Handing Over Anesthetist

3. Receiving PACU Nurse