Pre-Operative Assessment

Question 1

Purpose of Pre-Op Assessment?

Answer 1

1. Allay fear and anxiety
2. Identify potential anaesthetic difficulties
3. Improve safety by assessing and quantifying risk
4. Optimise plan of peri-operative care
5. Provide opportunity for explanation and discussion

Question 2

Ease of intubation score?

Answer 2

Malampatti Score

1. Uvula, soft palate and pillars visible
2. Uvula, soft palate, fauces
3. Base of uvula visible, soft palate visible
4. Only hard palate visible

Question 3

ASA Grades?

Answer 3

1. Healthy, no disease
2. Mild systemic disease without functional limitations
3. Severe systemic disease with substantiative functional limitations
4. Severe systemic disease which is a constant threat to life
5. Moribund patient who is not expected to survive without operation
6. Brainstem dead patient whose organs are being removed

Question 4

Grades of Surgery?

Answer 4

Minor, intermediate, major

Question 5

Maximum volume pre-surgery consumption?

Answer 5

30ml

Question 6

Minimum Fasting Times

Answer 6

Solids and milk containing drinks- 6 hours
Breast fed infants- 4 hours 
Clear fluids- 2 hours (1 for children)
Alcohol- 24 hours 
Boiled sweets and chewing gum are ok

Question 7

Factors that delay gastric emptying

Answer 7

• Metabolic (diabetes, RF)
• Pyloric stenosis (6 week old boys)
• Mechanical (pregnancy, obesity)
• Trauma (RTA, head injury)
• Others (high fat, anxiety)

Question 8

RSI Process

Answer 8

• Preoxygenation, Et02>90
• One induction agent plus one muscle relaxant
• Thiopentone/propofol
• Suxamethonium/rocuronium
• Cricoid pressure, no ventilation, remove pressure after confirmation of tube position (EtC02)