Pre-AMS Flashcards
Outline the American Society of Anethesiologicals (ASA) classification
- Normally healthy patient
- Mild systemic disease
- Severe systemic disease that limits activity but is not incapacitating
- Incapacitating systemic disease which poses a constant threat to life
- Moribound: not expected to survive 24h even with operation
Suffixe E is used to denote Emergency (eg 2E)
What blood tests should ALWAYS be performed preoperatively and for what reason?
- U&E - renal failure?
- FBC - anaemia inc risks [Hb <100 tell anaesthetist], baseline
- Blood glucose (finger-prick)
When should a cross-match be performed?
Cross-match - predicted & held for 24hr
When should LFTs be performed
- Jaundice
- Malignancy
- Alcohol Abuse
When should Amylase be performed
Acute abdo pain
When should Blood Glucose be performed?
Diabetics
When should Clotting studies be performed?
- Live/ renal disease
- DIC
- Massive blood loss
- On;
- Valproate
- Warfarin
- Heparin
When should Sickle test be performed?
- Malarial area origins
- Africa, West Indies or Mediterranean
When should Thryoid FTs be performed
Thyroid disease
When should Spirometry be performed
Obstructive/ restrictive lung pathology
When should a CXR be performed
- Abso, Cardio, Thoracic, Thyroid, Neck, Head
- Neurosurgery [due to prolonged anaethesia/ postop ITU]
- Lymph node surgery
- >65 yrs
When should ECG be performed
- >65yrs
- Poor exercise tolerance
- Hx of cardiovascular/ rheumatological conditions
When sould an Echocardiogram be performed
Suspicion of LV dysfunction
What is suxamethonium
Agent of choice for rapid paralysis (rapid metabolism)
Depolarising muscle relactant
Fasiculations then paralysis
Outline the cause of Suxamethonium Apnoea
- Incapable of metabolising drug sufficiently rapidly enough
- Remain paralysed & unable to breath post-surgery as they cannot regain muscle function
Causes;
- Metabolised by Cholinesterase, 10% excreted by kidney
- Congenital/ inherited - varies with phenotype
- Aquired
- Pregnancy, liver/kidney disease/ Hypothyroidism
- Drugs: methotrexate, monoamine oxidase inhibitors
