Periop

Question 1

What’s the ASA score

Answer 1

American Society Anaesthesiology classification to identify pre-op physical status.

1= healthy
2 = mild systemic disease
3 = severe systemic disease
4 = severe systemic disease which is a constant threat to life
5 = moribund pt won’t survive without surgery
6 = Brain dead

Question 2

Recommendations post-splenectomy?

Answer 2

Post-op: Risk rebleeding, nil heavy lifting/contact sport/bikes/horse riding 6/52

Spleen registry:
- Vaccinations x5 pre/DC. Daily abx plus emergency dosing. Malaria chemoprophylaxis for travel.

• Education for emergency presentation with infections, animal bites/scratches
• Link in with GP, improve immunity, health advocacy smoking cessation, optimisation of comorbbidities

Question 3

How do you test for asplenia?

Answer 3

Blood film for Howell Jolly bodies (abnormal RBCs healthy spleen filters out)

Question 4

What’s the aim of spleen registry Australia?

Answer 4

To prevent serious infection in people without a functioning spleen by education for many specific infection prevention strategies

Question 5

What are standard precautions?

Answer 5

Guidelines designed to reduce infectious disease transmission.

Universal standards regardless of whether pts have known or unknown infections- all pts considered potentially infectious

Question 6

What are your priorities for bleeding?

Answer 6

Prevention
Immediate haemorrhage control
Identification and reversal of coagulopathy
Escalate for Blood product transfusion and call for help
Monitoring for and management of recurrent bleeding