Pre-Op Assessment

Question 1

What are the effects on the body of surgery?

Answer 1

Stress response

Fluid shifts

Blood loss

CVS, resp, renal and metabolic stress

Question 2

What considerations need to be made prior to anaesthesia?

Answer 2

Known co-morbidities of the patient

Unknown pathologies of the patient

Nature of surgery

Anesthetic techniques to be used

Post-op care

Question 3

What is the anaesthetists role pre-op?

Answer 3

Assess the patient

Identify high risk patients

Minimise risk to all patients

Inform and support patient decisions

Consent the patient

Question 4

Why is a pre-op assessment important?

Answer 4

It reduces:

• Anxiety
• Delays
• Complications
• Length of stay
• Mortality

Question 5

What are the components of a pre-op assessment?

Answer 5

History

Examination

Investigations

Question 6

What needs to be established during a pre-op history?

Answer 6

1 - Known co-morbidities

2 - Unknown co-morbidities

3 - Ability to withstand stress

4 - Drugs and allergies

5 - Previous surgery and anesthesia

6 - Reflux & obesity

Question 7

What system is used to assess the health of a patient prior to surgery?

Answer 7

ASA Grading

ASA1 - Healthy patient

ASA2 - Mild to moderate systemic disturbance

ASA3 - Severe systemic disturbance

ASA4 - Life threatening disease

ASA5 - Moribund patient

Question 8

What system is used to assess exercise tolerance prior to surgery?

Answer 8

METs

Question 9

What are the most important conditions to consider during surgery?

Answer 9

Hypertension

Ischaemic heart disease

Heart failure

Asthma

COPD

Diabetes

Epilepsy