Procedure Complication Checklist – Overview
Procedures are common in ED, and unfortunately, complications do occur — some of which can cause significant harm. This new Procedure Complication Checklist is a quality improvement initiative designed to:
Support safer patient care by helping clinicians recognise, document, and act early when complications occur.
Provide a checklist-style reminder of the key steps to follow when a complication arises.
Improve communication with handover teams and future care providers by clearly documenting what happened and what follow-up is required.
When to Use It
The sheet is for any procedure with potential for lasting patient harm — from intramuscular injections (IM) or IV line insertions (if there's arterial involvement), up to higher-risk procedures like chest drains.
Examples where it should be used:
Arterial puncture during cannulation.
Procedural complications with potential for delayed harm (e.g. pneumothorax after central line insertion).
Examples where it does not need to be used:
Missed IV attempts.
Transient events (e.g. sedation-related laryngospasm that resolved without consequence).
If you're unsure, use your judgement — and feel free to use the form anyway. It’s there to help, not penalise.
Who Can Fill It Out?
Anyone involved in the patient’s care — nurse, doctor, proceduralist, or assistant — can complete the form.
It complements, but does not replace, a Datix report or other documentation.
Why It Matters
This form does not trigger any automatic consequence — but it does help ensure:
The event is properly documented.
Appropriate follow-up is arranged.
Key systems are notified (e.g. Datix, ACC, M&M review if needed).
Staff are supported through the process, including access to peer debrief or email support.
Where to Find It
The sheet is located in D17 of the paperwork tower, near the EPIC/Flow Nurse desk.
Background
This initiative arose after a case of pseudoaneurysm and compartment syndrome following an unrecognised arterial puncture during IV cannulation.
A staff survey showed that many clinicians were unaware of or not consistently completing all the steps that would be considered standard of care in managing procedural complications.
It was developed collaboratively with Greg and Liz, and input from SMOs, RMOs, and ACNMs.
In short: this sheet is a practical, supportive tool to help us all respond better to procedural complications. It’s not about blame — it’s about improving care, documentation, communication, and safety.
Let’s use it well.