Operative assessment Flashcards
Why is a history of a) cardiovascular b) respiratory disease required?
a) increased risk of acute cardiac event during anaesthesia
b) affects the oxygenation of the patient
What aspects of past anaesthetic history should be enquired?
Has the patient had general anaesthesia before; have they suffered any previous post-op nausea and vomiting
What is the ASA grade?
Correlates with risk of post-op complications and mortality; goes from I (normal, healthy) to V (moribund)
Standard blood tests prior to surgery? (5)
FBC U and E's to assess renal function LFTs Clotting G&S/X-match
What aspects of the airway are examined? (4)
Degree of mouth openining (inter-incisor distance)
Teeth- loose?
Oropharynx- Mallampati score
Neck
How is Mallampati score calculated?
I- soft palate, uvula and tonsillar pillars visualized
II- soft palate, uvula seen; tonsillar pillars not visible
III- only base of uvula seen
IV- uvula not visualized
What does Mallampati score predict?
Degree of difficulty of intubation
Examination of neck in pre-op assessment?
ROM- flexion, extension, lateral flexion Thyromental distance (with neck in maximal extension)
What does a thyromental distance of less than 6.5cm suggest?
Difficult intubation