NOM : ………………………………………………………………

POST NOM :………………………………………………………. Heure du début :……………………………

Age :………………………………………………Sexe :………… Heure de la fin :……………………………

COMPTE RENDU OPERATOIRE

1. Indication :……………………………………………………………………………………………………………….
2. Acte :
3. Equipe Chirurgicale :
3.1. Chirurgien :………………………………………………………………………………………………………….
3.2. Assistant(S) :………………………………………………………………………………………………………
4. Equipe anesthésique :………………………………………………………………………………………………
5. Ambulant :…………………………………………………………………………………………………………………
6. Type d’anesthésie :…………………………………………………………………………………………………….
7. Nombre des compresses avant l’intervention
8. Description
8.1. Position:……………………………………………………………………………………………………………..
8.2. Désinfection du site opératoire :…………………………………………………………………………
8.3. Drapage :…………………………………………………………………………………………………………….
8.4. Type d’incision :…………………………………………………………………………………………………..
Découvertes:………………………………………………………………………………………………………..
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Actes :……………………………………………………………………………………………………………………..
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 Incidents :……………………………………………………………………………………………………………………….
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Hémorragie :……………………………………………………………………………………………………………………
Nombre des compresses après l’intervention :………………………………………………………………..
Diagnostic peropératoire :……………………………………………………………………………………………….

INSTRUCTIONS POST-OPERATOIRES
a. Liquides :
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b. Médicaments :
R/…………………………………………………………. R/………………………………………………………
R/…………………………………………………………. R/……………………………………………………...
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R/…………………………………………………………. R/……………………………………………………..
R/…………………………………………………………. R/……………………………………………………..

c. Nursing:
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d. Bilan: ……………………………………………………………………………………………………………………………….
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Kinshasa, le……./……./202...
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