Pre-operative Assessment and Preparation Flashcards
what is the role of the anaesthetist pre-op?
- assess patient
- identify high risk
- optimise patient health
- minimise risk
- inform and support patients decisions
- consent
what will a pre-op assessment history and exam involve?
Known co-morbidities:
- severity
- control
Unknown co-morbidities:
- systemic enquiry
- clinical exam
Ability to withstand stress:
- exercise tolerance
- reason for limitation
- cardio-respiratory disease
-drugs and allergies
previous surgery and anaesthesia
potential anaesthetic problems:
- airway
- spine
- reflux
- obesity
rarities/family history:
- malignant hyperpyrexia
- cholinesterase deficiencyy
what pre-operative investigations can be performed by the anaesthetist?
cardiovascular:
- ECG
- exercise tolerance test
- echo
- myocardial perfusion scan
- stress echo
- cardiac catheterisation
- CT coronary angiogram
respiratory:
- saturations
- ABG
- CXR
- peak flow
- FVC/FEV
- gas transfer
- CT chest
outline the ASA grade
american society anaesthetists
- ASA1: otherwise healthy patient
- ASA2: mild to moderate systemic disturbance
- ASA3: severe systemic disturbance
- ASA4: life-threatening disease
- ASA5: moribund patient
- ASA6: organ retrieval
what medication should be stopped before an operation?
anti-diabetic medication
anticoagulants
