pre-op assessment Flashcards
1
Q
why pre-op assess ?
A
reduce; anxiety delays cancellations complications length of stay mortality
2
Q
what should be assessed in pre-op history ?
A
known comorbidity severity and control
unknown comorbidity - systematic enquiry, exam
ability to withstand stress - exercise tolerance
drugs and allergies
previous surgery and anaesthesia
potential anaesthetic problems - airway, spine, reflux, obesity
3
Q
what investigations should be done pre-op ?
A
ECG, exercise tolerance, ECHO, perfusion scan, CT coronary angiogram
sats, ABG, CXR, peak flow, FVC/FEV
4
Q
what are the ASA gradings ?
A
1 - otherwise healthy patient 2 - mild to moderate systemic disturbance 3 - severe systemic disturbance 4 - life threatening disease 5 - moribund patient 6 - organ retrieval
5
Q
what is on the cardiac risk index ?
A
high risk surgery IHD CHF cerebrovascular disease diabetes renal failure
6
Q
what are the MET scores for exercise tolerance ?
A
2 - walk around house 3 - do light housework 4 - walk 100-200 metres flat 5 - climb flight of stairs or walk up hill 6 - walk on flat at brisk pace 7 - play golf, mountain walk, dance 8 - short distance 9 - do strenuous exercise or heavy physical work
7
Q
what pre-op medication is stopped ?
A
anti-diabetic medication
anticoagulants
