1. CPSO Peer Assessment Form History & Physical (Items 2 - 8) Covered by PAU visit and you need to indicate you reviewed OR – you need to complete in Preop Manager in OR corridor (#8 – VS done in SDCU)           
Airway Exam & ASA (Items ) Although covered by PAU visit, as attending Anesthetist you need to record your own A/W & ASA assessments.

2. Medications (Item 12) Covered by Medication Reconciliation List and you need to indicate you reviewed     
Premedication (Item 13) Documented in SDCU notes     
NPO Status (Item 14) Indicate that you confirmed this yourself     
Investigations (Item 15) Review in Preop Manager or in vOacis – need to say you did it.

3. Anesthetic Plan (Item 16) You need to document what the Anesthetic Plan is that you have recommended    
Anesthetic Problems (Item 17) List problems identified     
Patient Discussion - Risks/Benefits & Options (Item 18) Indicate that you have discussed these issues with the patient        

4. Equipment Check (Item 2) Needs to be documented, including Gas Machine ID#    
GA Induction (Item 3) Technique, drugs, etc 
Airway Management (Items 4 & 5) Documenting routine and difficult airway management
Mechanical Ventilation (Item 6) Ventilator Mode and physio- logic parameters associated

5. Invasive Monitoring (Item 7a) Needs to be documented: insertion, data    
Capnography Inhalational Agents (Items 7b & 7d) Evidence of use    
Temperature / Urine Output (Items 7c &7e) Needs to be documented   
Depth of Anesthesia (Item 7f) Unclear how this is to be done

6. Patient Position (Item 8) Documented; possible injury risks addressed    
Eye Care (Item 9) Documented   
IV Lines: Sites & Sizes (Item 10) Documented    
IV Fluids / Fluid Plan (Items 11 & 12) Documented      
Blood Loss / Replacement (Item 13) Documented

7. Neuraxial & Peripheral Blocks (Items 15 & 16) Documented in detail – with technique, equipment and adequacy of block; Include complications, if present      
Monitoring after Blocks (Item 17) Documented in PACU
Drug Administration (including Narcotics) (Items 18 & 19) Fully documented
Operative / Emergent Events (Item 20) Fully documented