Anaesthetic Protocols Flashcards

1
Q

Outline ASA grading

A
  • ASA I: A normal healthy patient
  • ASA II: A patient with mild systemic disease
  • ASA III: A patient with severe systemic disease
  • ASA IV: A patient with severe systemic disease that is a constant threat to life
  • ASA V: A moribund patient who is not expected to survive without the operation
  • ASA VI: Declared brain-dead patient whose organs are being removed for donor purposes
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2
Q

What are some examples for ASA 2, 3?

A

ASA II: Mild diseases only without substantive functional limitations.

  • Current smoker
  • Social alcohol drinker
  • Pregnancy
  • Obesity (30 < BMI < 40)
  • Well-controlled Diabetes Mellitus/Hypertension
  • Mild lung disease

ASA III: Substantive functional limitations; One or more moderate to severe diseases.

  • Poorly controlled Diabetes Mellitus/Hypertension
  • COPD
  • Morbid obesity (BMI 40)
  • Active hepatitis
  • Alcohol dependence or abuse
  • Implanted pacemaker, moderate reduction of ejection fraction
  • End Stage Renal Disease (ESRD) undergoing regularly scheduled dialysis
  • History (>3 months) of Myocardial infarction
  • Cerebrovascular accidents
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3
Q

What are some examples for ASA 4, 5?

A

ASA IV

  • Recent (< 3 months) of Myocardial infarction
  • Cerebrovascular accidents
  • Ongoing cardiac ischaemia or severe valve dysfunction
  • Severe reduction of ejection fraction
  • Sepsis
  • DIC, ARD or ESRD not undergoing regularly scheduled dialysis

ASA V

  • Ruptured abdominal/thoracic aneurysm
  • Massive trauma
  • Intra-cranial bleed with mass effect
  • Ischaemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction
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4
Q

What are causes of Post Operative Pyrexia?

A

Early causes of post-op pyrexia (0-5 days) include:

  • Blood transfusion
  • Cellulitis
  • Urinary tract infection
  • Physiological systemic inflammatory reaction (usually within a day following the operation)
  • Pulmonary atelectasis - this if often listed but the evidence base to support this link is limited

Late causes (>5 days) include:

  • Venous thromboembolism
  • Pneumonia
  • Wound infection
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5
Q
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