Pre-operative assessment

Question 1

How far in advance should a pre-operative assessment take place?

Answer 1

2-4 weeks

Question 2

Why does a pre-operative assessment take place?

Answer 2

To identify co-morbidities that may lead to complications during anaesthetic, surgery, or the post-operative period

Question 3

What history do you need to take?

Answer 3

History of presenting complaint
Past medical history
Past Surgical history
Past Anaesthetic history
Drug history
Family history
Drug history

Question 4

What important points in the past medical history should you illicit?

Answer 4

Cardiovascular disease

• hypertension
• exercise tolerance

Respiratory disease

• COPD
• asthma

Renal disease
- features of renal disease can increase risk of surgical complications

Endocrine disease

• diabetes
• thyroid disease

Risk of pregnancy

Question 5

Why is past surgical history important?

Answer 5

Any previous issues?

Any issues with anaesthesia?

Question 6

Why is drug history required?

Answer 6

To ensure full medical history is taken

Find out which medications need stopping pre-surgery

Find out any drug allergies

Question 7

What is taken in social history?

Answer 7

Alcohol
Smoking

Home situation

• who lives with patient
• stairs if applicable

Question 8

What investigations are done?

Answer 8

Heart sounds
Lung bases
ECG
Bloods
Urinalysis
MRSA swabs

Question 9

What blood tests are done?

Answer 9

FBC

• assess anaemia
• assess thrombocytopenia

U&Es
- assess baseline renal function

LFTs

• assess liver metabolim
• assess synthesising function

Clotting screen
- indicates deranged coagulation