Pre-op And Med Flashcards
Elective surgeries ;steroid therapy effect
Suppresses the patient adrenocortical function
Depresses lymphocytes and B function
Elective surgeries:contraceptives
Can cause DVT -should be stopped 6weeks before surgery
Elective surgeries: alcohol
*pulmonary and CVS negative effect
Wound healing delay
Pre-operative prep includes
Pre-op history
Pre-op examination
Pre-op investigation
Pre-op treatment;where required
Special prep:where indicated
Informed consent
Ward prep for theatre
Investigation from 40 and above
Chest X ray:chronic airway disease and cardio megaly
ECG:Prone to cardiac disease
FBS-type 2 DM
Investigations done when indicated-The why
Blood group and cross matching
Serum electrolytes and blood urea in malnutrition
Water and electrolyte imbalance in - and - disorders
Chest X ray in -
ECG in CVS
Plasma proteins in - and -
G6PD
FBG in diabetes
Prothrombin and clotting stuff in patients with bleeding tendency
Blood group and cross matching
Serum electrolytes and blood urea in malnutrition
Water and electrolyte imbalance in myopathies and genitourinary disorders
Chest X ray -large thyroids
ECG in CVS
Plasma proteins in malnutrition and liver conditions
G6PD
FBG in diabetes
Prothrombin and clotting stuff in patients with bleeding tendency
Investigations done when indicate
Blood group and cross matching
Serum electrolytes
Chest X ray
ECG
Plasma proteins
G6PD
FBG
prothrombin and clotting factors
Special Prep
Obstructive Jaundice
I.M vitamin K (4-5 days before Op)
Special prep
Diabetes
Oral hypoglycemic patients-replace biguanides with sulphonylureas(short acting)b
-iinsulin replacement to soluble insulin
10%- +10%IU - +10mmol Kcl -mornibg of surgery till post op period feeding
Blood glucose and serum potassium -2hrly monitoring for 4-10 and - moml/L
Oral hypoglycemic patients-replace biguanides with sulphonylureas(short acting)b
Long acting insulin replacement weighs soluble insulin
10%Dextrose water +10%IU soluble insulin +10mmol Kcl -mornibg of surgery till post op period feeding
Blood glucose and serum potassium -2hrly monitoring for 4-10 and 3.5-4.5 moml/L
Special op
Steroids
> 3months-replace with hydrocortisone (200mg at 7 am and 4pm) to prevent adrenaline collapse
Ward prep
-before anesthesia and operation
Emptying bowel and bladder
Emptying stomach
Remove dentures
Watches,ear-ringe and nail varnish removed
-(1 hour before surgery)
Patient must be labelled with -,- and - to be performed
Informed consent before anesthesia and operation
Emptying bowel and bladder
Emptying stomach
Remove dentures
Watches,ear-ringe and nail varnish removed
Pre-anaesthesia (1 hour before surgery)
Patient must be labelled with name ,ward and op to be performed
Why dentures removal
-may become displaced during anesthesia and cause air way obstruction
Why remove elaborate hair styles
To make intubation easier
To put the patient’s head at atlanto-occupital joint
ASA classification
Class 1-3
Class I
A normally healthy individual
0.1%
Class II
Mild systemic disease
0.2%
Class III
Severe systemic disease that is not incapacitating
1.8-4.3%
ASA classification (IV-E)
Class IV
Incapacitating systemic disease that is a constant threat to life
7.8-23%
Class V
Moribund patient not expected to survive 24 hrs with/without operation
>50%
Class VI
Brain-dead patient whose organs are being removed for donor purposes
Class E
Suffix for emergency operation
