Exam 1 Flashcards
What is AMPLE
Emergent Physical Examination
A= Allergies
M= Medications
P= Past Medical History
L= Last meal eaten
E= Events leading up to need for surgery/procedure
In an emergency, assume _________ for last meal eaten
8-24hrs full stomach.
sympathetic system causes GI to slow
What is the calculation for BMI?
Metric: BMI= weight (kg) /height (m^2)
Imperial: 703 x weight (lbs) /height (in^2)
What BMI is underweight
< 18.5
What BMI is Normal
18.5-24.9
What BMI is Overweight
25.0-29.99
What BMI is Obese
30.00 and above
What is RCRI
Revised Cardiac Risk Index
Prediction tool recommended by ACC/AHA that estimates risk of cardiac complications after surgery
What are the Red Flags?
Bowel/bladder dysfunction
Saddle anesthesia
Bilateral leg weakness
Severe, sudden onset headache
Fever, Weightloss, night sweats - TB, cancer signs
Recent injury
History of cancer
Court case that established the practice of informed consent
Salgo v. Leland Standford Hospital
Examples of High risk procedures
Aortic and major vascular
Peripheral vascular
Examples of intermediate risk procedures
Intraabdominal surgery
Intrathoracic surgery
Carotid endarterectomy
Head/neck surgery
Examples of low risk procedures
ambulatory surgery
breast surgery
endoscopic procedures
cataract surgery
skin surgery
urologic surgery
orthopedic surgery
Functional capacity is ____
Assessment of cardiopulmonary fitness
Estimates patient risk for major post-op morbidity and mortality
Determines if further testing is necessary
Poor functional capacity= increased Peri-operative risk
Functional capacity is measure in ____
METS (metabolic equivalent of task)
rate of energy consumption at rest
1 MET = 3.5mL/kg/min
of METs that indicate good functional capacity
> 4 METs
Urgency of surgery that is life or limb would be threatened if surgery did not proceed within 6 hours or less
Emergency
Urgency of surgery that is life or limb threatened if surgery did not proceed within 6-24hours
Urgent
Urgency of surgery where delays exceeding 1-6 weeks would adversely affect patient outcomes
Time-sensitive
What is the ASA classification for the following:
Normal healthy patient, non smoker, no alcohol
ASA 1
What is the ASA classification for the following:
Patient with mild systemic disease;
examples: current smoker, social alcohol, pregnant, obesity, well-controlled DM, mild lung disease
ASA 2
What is the ASA classification for the following:
Patient with severe systemic disease:
ex. Substantial functional limitations, one or more moderate to severe diseases. Poor DM, morbid obesity, COPD, HTN, pacemaker, ESRD on dialysis etc.
ASA 3
What is the ASA classification for the following:
A patient with severe systemic disease that is a constant threat to life; recent MI, CVA, TIA, CAD/stents, cardiac ischemia, ARDS, DIC, sepsis
ASA 4
What is the ASA classification for the following:
A moribund patient who is not expected to survive without this operation; ruptured abdominal or
ASA 5
What is the ASA classification for the following:
a declared braindead patient whose organs are being removed for donor purposes
ASA 6
P wave is positive in which leads?
I, II, aVF, V4-6
T waves are positive in which leads?
I, II, V3-6
