Q. Are there situations, such as when there are two separate procedures, when we should conduct more than a single time-out?
A. Whenever there is more than one procedure being performed by separate procedure teams, there needs to be a time-out prior to each team commencing their procedure. This does not apply to those situations where the same team is performing multiple components during a single procedure. For example, a first team performs a mastectomy and a second team performs reconstructive surgery. Another example would be the performance of a spinal or regional block by anesthesia prior to a general or orthopedic surgery.
A specific situation requiring two time-outs is when hospital policy or law/regulation requires two separate consents, such as for a Cesarean section and a tubal ligation. Two separate time-outs should occur for these situations.
In all other circumstances, each organization may define when more than one time-out must be performed.