Pre-Op Evaluation and Risk Flashcards
Who gets an EKG with no pertinent prior medical history?
Everyone over 50
What is an emergent surgery?
life or limb is threatened if not in OR within 6 hours
what is an urgent surgery?
life or limb threat if not in OR within 24 hours
what is a time-sensitive surgery?
delay of 1-6 wekes for further evaluation would negatively affect outcome
elective surgery is defined as?
surgery that can be delayed for up to a year?
what are the major surgical cardiac complications?
- MI
- v fib
- cardiac arrest
- complete heart block
- pulmonary edema
what surgeries are considered high cardiac risk?
- emergent major operations (esp. in elderly)
- aortic and other major vascular procedures
- peripheral vascular procedures
- prolonged procedures with large fluid shifts/blood loss (greater than 3 hours)
what surgeries are considered intermediate cardiac risk?
carotid endarterectomy
head and neck
intraperitoneal and intrathoracic
orthopedic
prostate
what surgeries are considered low cardiac risk
endoscopic procedures
superficial procedures
cataract
breast
mole removal
What HTN medications cannot be taken the morning of surgery with sips?
ACEs
ARBs
diuretics
why is pre-operative B-blockade no longer empirically advised for all high risk surgical patients?
stroke risk?
What’s the most important factor for determining pulmonary surgical risk?
age
What blood sugar level incrementally increases surgical site infection?
BS >140 mg/dL
What happens when steroid doses in chronic steroid patients are inadequate prior to surgery?
Addisonian crisis: cortisol drop causes weakness, fatigue, mental confusion and hypotension
what are the risks of pre-op steriods?
