Pre-anesthesia guidelines or minimum surgical requirements

Question 1

Please send all PAT within ______ prior to the scheduled time of the procedure plan whenever possible

Answer 1

72 hours

Question 2

Obtain all documents such as _______ (4) over the past 5 yrs

Answer 2

stress test, heart cath, TEE, or echo

Question 3

Exclusions for a pregnancy test in women include: (4)

Answer 3

s/p total hysterectomy, b/l salpingoophporectomy, 1 yr s/p menopause, prior to menarche

Question 4

pregnancy test in women must be less than:

Answer 4

7 days old

Question 5

Always notify anesthesia if lab values for K:

Answer 5

<3.2 or >5.2

Question 6

accucheck may be substituted for:

Answer 6

serum glucose

Question 7

hemacue may be substituted for:

Answer 7

HnH

Question 8

Diabetes:

Answer 8

• HnH
• BMP
• EKG

Question 9

RVSC restrictions include: (11)

Answer 9

1. AICD
2. Anaphylactic allergic rxn to latex (documented)
3. Airway compromised
4. BMI≥45
5. EF< 50%
6. Hx difficult intubation
7. Hx malignant hyperthermia
8. Health unstable
9. OSA (rq sleep study)
10. Oxygen use at home
11. Mechanical vent dependent

Question 10

Always notify anesthesia if lab values for plt:

Answer 10

<100

Question 11

Always notify anesthesia if lab values for Na:

Answer 11

<130

Question 12

Always notify anesthesia if lab values for hgb:

Answer 12

<10 (or a decrease of 20)

Question 13

H&P within ________ of surgery and updated within ____ the procedure

Answer 13

30 days; 24 hrs

Question 14

Pacemaker/AICD interrogation within _____ of surgery

Answer 14

<6 mos with interrogation form filled out completely

Question 15

EKG and CXR must be less than ___ old

Answer 15

<6 mos

Question 16

Lab results must be less than ___ old

Answer 16

<60 days

Question 17

Cardiac clearance recommended for all patients with:

Answer 17

cardiac history and/or see a cardiologist

Question 18

Symptomatic rheumatoid arthritis:

Answer 18

Flexion/extension cervical spine X-ray (case by case basis)

Question 19

Symptomatic pulmonary disease: 3

Answer 19

• HnH
• EKG
• CXR

Question 20

Hypertension/heart disease: 4

Answer 20

• HnH
• BMP
• EKG
• CXR (IF CHF HX)

Question 21

Systemic steroids: 1

Answer 21

BMP

Question 22

Kidney disease: 4

Answer 22

• HnH
• BMP
• EKG
• protein

Question 23

Coumadin: 1

Answer 23

PT/PTT/INR

Question 24

Aminophylline: 3

Answer 24

BMP
lithium
theophylline levels

Question 25

Digoxin: 1

Answer 25

K

Question 26

Vascular dz: 4

Answer 26

- HnH - Creatinine - K - EKG

Question 27

Smokers >50 packs per year: 3

Answer 27

``` HnH EKG CXR --Formula: # yrs x PPD= pack years *all smokers encouraged not to smoke day of surgery ```

Question 28

Liver dz: 3

Answer 28

AST/ALT Alk phos PT/PTT/INR

Question 29

Seizures if within 1 month: 1

Answer 29

Medication level

Question 30

Men <40 yo:

Answer 30

Based on clinical disease

Question 31

Men 40-64 yo:

Answer 31

EKG and labs based on clinical disease

Question 32

Men >65 yo:

Answer 32

- HnH - BMP - EKG

Question 33

Women <50 yo:

Answer 33

HnH (Not necessary unless after menarche) and serum beta-hcg test

Question 34

Women 65+ yo:

Answer 34

- HnH - BMP - EKG

Question 35

Women 50-64 yo:

Answer 35

HnH, serum beta-hcg test, EKG

Question 36

if serum beta hcg test >7 days old, rq. ______

Answer 36

urine pregnancy test

Question 37

A copy of _____ and _____ should be obtained prior to surgery if possible:

Answer 37

advance directives | old anesthesia records

Question 38

Hyperglycemia and ADA risk factors rq. ________ by _______

Answer 38

E and M by pts PCP