Pre-Op Care Flashcards
anaesthetic fitness assessment scale?
ASA
when to stop warfarin before surgery?
5 days prior
what to do if stopping warfarin in high-risk patients?
LMWH or unfractionated heparin used as a bridge
who is a high risk warfarin patient?
mechanical heart valve
recent VTE
when to stop DOACs before surgery
48 hours prior
when to stop clopidogrel before surgery?
7 days prior
when to stop OCP
4 weeks prior to surgery
NSAIDs in surgery
withheld
steroids in surgery
add IV hydrocortisone
double dose once eating and drinking post
ACEI/ARBs on day of surgery
stop on day due to risk of profound hypotension
PPIs/H2RAs
given on day
offer to BMI >30
what has to be present to have capacity?
understand
retain
weigh-up
communicate
consent form types
- Consent form 1= patient consenting to procedure
- Consent form 2= parental consent on behalf of a child
- Consent form 3= where the patient won’t have consciousness impaired
- Consent form 4= where the patient lacks capacity
HbA1c before surgery
<69 before elective surgery
triad of balanced anaesthesia
depress consciousness
block painful stimuli
relax skeletal muscle
two ways to give anaesthetic
IV
inhalation
fasting requirements prior to surgery
no food 6 hours prior
sips of water for 2 hours prior
IV hypnotic agents
propofol (GABA mediated)
ketamine (NMDA)
inhaled hypnotic agents
sevoflurane
desflurane
NO
risks of hypnotic agents
sore throat PONV accidental awareness aspiration dental injury anaphylaxis cardio malignant hyperthermia (dantrolene) death
depolarising muscle relaxants
suxamethonium
action of suxamethonium
hyper-stimulates NMJ
used in RSI
non-depolarising muscle relaxants
rocuronium
atracurium
action of non-depolarising
competitive antagonists of ACh at NMJ
