Pre-op assessment and preparation Flashcards
Name some trauma of surgery
Stress response, fluid shifts, blood loss, cardiovascular, respiratory and metabolic stress
What are the risks of general anaesthesia?
Drug induced reversible coma
CNS, Cardiac and Respiratory Depression
Drug Interaction
What are the risks of regional anaesthesia?
Profound sympathectomy
Neurological sequelae
What is ASA1?
Otherwise healthy patient
What is ASA2?
Mild to moderate systemic disturbance
What is ASA3?
Severe systemic disturbance
What is ASA4?
Life threatening disease
What is ASA5?
Moribund patient
What is ASA6?
Organ retrieval
What must be considered before surgery?
Patient known co-morbitities/unknown pathology
Nature of surgery and anaesthetic techniques
Post op care
What must be considered in the anaesthetic history?
Known and unknown co-morbidities
Ability to withstand stress (exercise tolerance or CV-Resp disease)
Drugs and allergies
Previous surgery and anaesthesia
Potential anaesthetic problems such as airway/spine issues, reflux, obesity
What is considered cardiac risk?
High risk surgery Ischaemic heart disease Congestive HF CV disease Diabetes Renal failure
How is exercise tolerance scored?
Walk around the house = 2 METS
Do light housework= 3 METS
Walk 100-200 metres on the flat = 4 METS
Climb a flight of stairs or walk up a hill =5 METS
Walk on the flat at a brisk pace = 6 METS
Play golf, mountain walk dance, or any form of exercise = 7 METS
Run a short distance = 8 METS
Do either strenuous exercise or heavy physical work = 9 METS
What risks does alcohol bring to surgery?
Increased risk of infection and septic shock
What pre-op medications are contraindicated for surgery?
Anti-diabetic medication - can be taken as normal up to day of surgery but on day of surgery, dose may have to be halved or not taken at all
Anticoagulants
NSAIDS
Diuretics
