THEATRE/PERIOPERATIVE SPECIALIST PROCEDURES
Last Name: TAN First Name: LLOYD RAYMUND .
1 - No Knowledge 2 - Limited Knowledge 3 - Proficient
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1. GENERAL SURGERY Zimmer ✔
Abdominal perineal resection ✔ Disposable grounding pads ✔
Adrenalectomy ✔ 2.2 Drills: 1 2 3
Anaesthesia ✔ 3-M maxi driver ✔
Assist with intubation ✔ Codman craniotome ✔
Conscious sedation(administer) ✔ Hall air driver ✔
Manage malignant hyperthermia ✔ Hall dental ✔
Anal fissurectomy ✔ Hall neurotome ✔
Appendectomy ✔ Midax rex/anspach ✔
Breast biopsy ✔ Minidriver ✔
Cholecystectomy ✔ Stryker drills ✔
Colectomy ✔ Large battery stryker ✔
Colostomy/ileostomy ✔ Small battery stryker ✔
Exploratory laparotomy ✔ Surgairtome ✔
Gastrectomy ✔ Synthes A-O drill ✔
Gastroplasty ✔ Electrosurgical unit ✔
Herniorrhaphy: femoral, inguinal ✔ Emerson thoracic pump ✔
Hiatal herniorrhaphy:transabdominal ✔ Ethylene oxide steriliser/AMSCO ✔
Hiatal herniorrhaphy;transthoracic ✔ Eye magnet ✔
Hickman/Groshong/portacath ✔ Fibre optic laminator ✔
Hydrocelectomy ✔ Flash autoclave-AMSCO ✔
Imperforate anus reconstruction ✔ 2.3 Fracture tables 1 2 3
Lumbar sympathectomy ✔ Chick table/marquet table ✔
Oesophagoscopy ✔ Jackson table ✔
Umbilical hernia repair ✔ Rush table/skyton table ✔
Operating room protocols/procedures ✔ Hypo/hyperthermia unit ✔
Asceptic technique ✔ 2.4 Intestinal stapling devices ✔
Surgical attire ✔ EEA ✔
Sponge & lap counts ✔ GIA ✔
Care of specimens ✔ LDS ✔
Oancreatectomy/pancreatogram ✔ TA ✔
Pilonidal cystectomy ✔ Kreiselman resuscitator ✔
Portal caval shunt ✔ 2.5 Laser 1 2 3
Pyloric stenosis ✔ CO2 ✔
Radical mastectomy ✔ Eye ✔
Saphenous vein ligation ✔ Yag ✔
Sentinel node biopsy ✔ Other
Splenectomy ✔ Mesh graft ✔
Tenchkhoff catherter placement ✔ Microscopes ✔
Thyroglossal duct cyst excision ✔ Nerve stimulator ✔
Thyroidectomy ✔ Nitrous oxide bank ✔
Tracheotomy ✔ Othio suction units ✔
Vagotomy ✔ EQUIPMENT CONTINUED
2. EQUIPMENT Orthopaedic arm board with drain ✔
Argon beam coagulator ✔ Pleurevac disposable chest drainage ✔
Bair hugger ✔ Pneumatic tourniquet ✔
Blood/fluid warmer ✔ Sterad machine ✔
Argon beam coagulator ✔ Steri-vac aeration cabinet, 3m, portable ✔
Camera controller ✔ Steris unit ✔
Light source ✔ Suction unit, disposable ✔
Printers ✔ Tele-thermometer ✔
EQUIPMENT CONTINUED: Ultrasonic-cleaner- AMSCO ✔
Printers ✔ Vac-par positioner ✔
VCRs ✔ Vacuum curettage ✔
Cardiac monitor and pacemaker ✔ Washer sanitiseAMSCO ✔
Call saver ✔ Washer steriliser-AMSCO ✔
Cidex soak ✔ 3. EAR, NOSE & THROAT
Cry-ophthalmic unit ✔ Adenoidectomy ✔
Defibrillator/pacer ✔ Caldwell-Luc ✔
2.1 Dermatome: 1 2 3 Cataract extraction ✔
Brown ✔ Cleft lip/palate repair ✔
Padgett ✔ Closed reduction nasal fracture ✔
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Ethmoidectomy ✔ Hysterectomy, abdominal ✔
Excision of salivary gland tumour ✔ Hysterectomy, vaginal ✔
Eye enucleation ✔ Marshall, marchetti kranz ✔
Fenestration procedure ✔ Marsupialisation, Bartholin cyst ✔
Frontal flap sinus procedure ✔ Ovarian cystectomy ✔
Glossectomy ✔ Radium insertion ✔
Insersion of PE tubes ✔ Sacral spinus fixation ✔
Iridectomy ✔ Shirodkar procedures ✔
Laryngectomy ✔ Suction curettage ✔
Mandibulectomy ✔ Tuboplasty ✔
Mastoidectomy ✔ Viginal reconstruction ✔
Maxillary advancement with hip graft ✔ Vaginectomy/vulvectomy ✔
Maxillectomy ✔
Myringoplasty ✔ 6. NEUROLOG
Myringotomy ✔ A-V malformation ✔
Nasal polypectomy ✔ Anterior cervical fusion ✔
Odontectomy ✔ Anterior laparoscopic spine ✔
Open reduction facial fracture ✔ Anterior lumbar interbody fusion ✔
Open reduction nasal fracture ✔ Burr holes: subdural hematoma ✔
Parotidectomy ✔ Carotid ligation ✔
Pharyngeal flap procedure ✔ Carpal tunnel release ✔
Radical neck dissection ✔ Cervical laminectomy-anterior ✔
Ranulectomy (tongue cyst) ✔ Cervical laminectomy-posterior ✔
Rhinoplasty/septoplasty ✔ Cervical sympathectomy ✔
Septoplasty ✔ Craniectomy for decompression ✔
Sinus endoscopy ✔
Sinusotomy ✔ NEUROLOGY CONTINUED:
Stapedectomy ✔ Cranioplasty/craniotomy: ✔
Submucous resection (SMR) ✔ Clipping of aneurysm ✔
Tonsillectomy ✔ Tumour excision ✔
Tracheostomy ✔ Steath craniotomy ✔
Tympanoplasty ✔ Discectomy ✔
4. ENDOSCOPIC PROCEDURE Hypophysectomy ✔
Bronchoscopy ✔ Insertion of nerve stimulators ✔
Colonoscopy ✔ Insertion of nerve pumps ✔
Culdoscopy ✔ Lumbar laminectomy/discectomy ✔
Esophagoscopy ✔ Myelomeningocele ✔
Gastroscopy ✔ Pedicle screw insertion ✔
Hysteroscopy ✔ Percutaneous micro discectomy ✔
Laparoscopic procedures: Posterior lumbar interbody fusion ✔
Appendectomy ✔ Shunt procedure/VP, VA/LP ✔
Cholecystectomy ✔ Spine fusion ✔
Cholanglogram ✔ Transphemoidal hypophysectomy ✔
Colon resection ✔ Ulnar nerve transfer ✔
Hernia repair ✔ Ventriculography ✔
Nissen fundoplication ✔ Ventriculostomy ✔
Salpingo-oophorectomy ✔ 7. OPTHALMOLOGY
Tubal ligation ✔ Cataract extraction with IOL ✔
Vaginal hysterectomy ✔ Corneal transplant ✔
Laryngoscopy ✔ Dacryocystectomy ✔
Microlaryngoscopy ✔ Dacryocystorhinostomy ✔
Mediastinoscopy ✔ Lid and muscle procedures ✔
Pelviscopy ✔ Orbital implant ✔
Signmoidoscopy ✔ Phaco emulsification ✔
Thoracoscopy ✔ Pterygium repair ✔
5. GYNECOLOGY Recession resection ✔
Anterior/posterior repair ✔ Repair orbial blowout fracture ✔
Bilateral tubal repair (BTL) ✔ Scleral buckle ✔
Caesarean section ✔ Vitrectomy ✔
Colpotomy ✔ 8. ORAL
Diagnostic laparoscopy ✔ Closed reduction facial fractures ✔
Dilation and curettage (D&C) ✔ Closed reduction facial wiring ✔
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Excision odontoma ✔ Repair hammer toes ✔
Extraction od deciduous teeth ✔ Sacro-iliac (SI) joint screws ✔
Extraction of impacted molars ✔ Sharrard procedure ✔
Fractured jaw ✔ Spica cast (application) ✔
LeFort osteotomies ✔ Spinal fusion ✔
Maxillary procedures with graft ✔ Tendon transplant (hand,foot) ✔
Paediatric dentistry ✔ Total joint replacement/revision: ✔
Sagittal osteotomy ✔ Total hip ✔
Temporomandibular joint (TMJ) ✔ Total knee ✔
TMJ arthroplasty ✔ Total shoulder ✔
TMJ exploration ✔ 10. PAEDIATRICS
9. ORTHOPEDICS Hernia ✔
Acetabular/pelvic ORIF ✔ Pylorotomy ✔
Achilles tendon repair ✔ 11. PHLEBOTOMY/IV THERAPY
Amputation-leg, arm ✔ Administer blood/blood products: ✔
Anterior crucial ligament repair ✔ Packed red blood cell ✔
Application of external fixations: ✔ Whole blood ✔
Extremities ✔ Assist with IA/IV therapy ✔
Pelvis ✔ Insertion of A-lines ✔
ORTHOPEDICS CONTINUED: Insertion of CVP-jugular ✔
Application of halo traction ✔ Insertion of CVP-subclavian ✔
Arthroscopy ✔ Insertion of swan-ganz ✔
Ankle ✔ Drawing blood from central line ✔
Elbow ✔ Drawing venous blood ✔
knee ✔ Starting IVs: angiocath ✔
Shoulder ✔ 12. PLASTICS
Arthrotomy ✔ Abdominal lipectomy ✔
Bipolar/unipolar hips ✔ Blepharoplasty ✔
Bunionectomy ✔ Mammoplasty ✔
Calcaneal reconstruction ✔ Augmentation ✔
Capulorrhaphy ✔ Reduction ✔
Carpal tunnel release ✔ Tramflaps/reconstructive mammoplasty ✔
Closed reduction fracture ✔ Mammoplasty- care of prosthesis ✔
Hand surgery with implants ✔ Mentoplasty ✔
Harrington rod instrumentation ✔ Otoplasty ✔
Dwyer procedure ✔ Pedicle grafts ✔
Heel cord lengthening ✔ Rhinoplasty ✔
Hip compression: nails, crews: ✔ Rhytidectomy (facelift) ✔
Jewett ✔ Scar revision ✔
Kuntscher rod ✔ Skin grafts ✔
Lottens ✔ Split thickness skin grafting ✔
Rush ✔ Tissue expenders ✔
Schneider ✔ 13. THORACIC & OPEN HEART
Zimmer ✔ Cervical rib excision ✔
Iliac crest bone graft ✔ Chamberlain procedure ✔
Insert Austin moor hip prosthesis ✔ Closed thoracotomy ✔
Intramedullary rods: ✔ Correction pectus excavatum ✔
Extraction ✔ Heller procedure ✔
Femoral ✔ Mitral commissurotomy ✔
Humeral ✔ Oesophagectomy ✔
Insertion ✔ Open heart procedures: ✔
Supracondylar ✔ Mitral/aortic valve replacement ✔
Tibial ✔ Patent ductus arteriosus ✔
Laminectomy ✔ Septal defect repairstetrology of fallot ✔
Olecranon bursa (excision) ✔ Pacemaker implantation- endocardial ✔
Open fracture reduction: ✔ Pacemaker implantation- myocardial ✔
Internal fixation ✔ Pericardiectomy ✔
Patellectoy ✔ Resection coarctation aorta ✔
Putti platt/bankart procedure ✔ Rib resection ✔
Rotator cuff repair ✔ Thoracoplasty ✔
Reduction with compression set ✔ Transthoracic diaphragmatic ✔
Reimplantation of digits ✔ 14. TRANSPLANT
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Bone ✔
Bone marrow ✔
Comeal ✔
Harvesting ✔
15. TRANSPLANT CONTINUED:
Heart ✔
Kidney ✔
Liver ✔
Lung ✔
Multi-organ ✔
Pancreas ✔
Skin ✔
16.0 TRAUMA
Bunrs ✔
Gunshot/stab wounds ✔
Abdomen ✔
Chest ✔
Head ✔
Motor vehicle accidents ✔
Traumatic amputations ✔
16. UROLOGY
Adult circumcision ✔
Cystectomy ✔
Cystoscopy/ureteroscopy ✔
Hypospadias repair ✔
Implants (penile, testicular) ✔
Lithotripsy ✔
Nephrectomy ✔
Orchiopexy ✔
Prostatectomy ✔
Perineal ✔
Supra-public ✔
Pyeloplasty ✔
Radical lymph node dissection ✔
Scott incontinence device ✔
TURP ✔
Ureteroscopy ✔
Vasectomy ✔
Vasovasostomy ✔
Ultrasonic lithotripsy ✔
Waterhouse procedure ✔
17. VASCULAR
A-V access graft ✔
Aortic aneurysm/graft replacement ✔
Endarterectomy/carotid- femoral ✔
Peripheral vascular bypass ✔
Resection carotid aneurysm, graft ✔
Thrombectomy/embolectomy ✔
Vena cava filter/umbrella ✔
19.EXPERIENCE Years EXPERIENCE Years EXPERIENCE Years
General 1 year Ophthalmology N/A Transplant N/A
Ent 1 year Oral N/A Trauma 4 months
Endoscopy N/A Orthopaedic 1 year Urology N/A
Ob/gyn N/A Plastics N/A vascular N/A
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Neurology 3 months Thoracic N/A
THEATRE/PERIOPERATIVE SPECIALIST PROCEDURES
AGE SPECIFIC PRACTICE CRITERIA
A. Newborn/Neonate (birth-30 days) F. Adolescents (12-18 years)
B. Infant (30days-1 year) G. Young Adults (18-29 years)
C. Toddler (1-3 years) H. Adults (30-64 years)
D. Preschooler (3-5 years) I. Older Adults (65 years +)
I. School age Children (5-12 years)
EXPERIENCE WITH AGE GROUPS A B C D E F G H I
Able to care to incorporate normal growth and development ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
Able to adapt method/terminology of patient instructions to their age, comprehension and maturity ✔ ✔ ✔ ✔ ✔ ✔ ✔
level
Can ensure safe environment reflecting specific needs of various age groups ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
16 CERTIFICATIONS:
COURSE COURSE COURSE
DATE(DD/M DATE(D DATE(DD/M
M/YY) D/MM/ M/YY)
YY)
BCLS/CPR 23/05/2019 Manual Handeling - Health & safety -
CNOR - Fire Procedures - Complaints handling -
ACLS - Infection - Control of substances 17-
control/MRSA Hazardous to health 18/12/2018
CRNFA - Reporting injuries - Cannulation -
diseases/dangerous
occurrences
ECG - - Provide Documentation
I confirm that the information given is true and accurate to the best of my knowledge
Signature_____________________________________ Date__October 5, 2020________________
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