Pre-Operative Assessment and Preparation Flashcards
State the role of the anaesthetist pre-operative
Assess, identify high risk, optimise, minimise risk, inform and support patients decisions, obtain consent
State what results from the trauma of surgery
Stress response, fluid shifts, blood loss, cardiovascular, respiratory, renal and metabolic stress
List conditions that may result in anaesthetic problems
Airway, spinal problems, reflux, obesity, rarities/family history - malignant hyperpyrexia, cholinesterase deficiency
ASA1
Otherwise healthy patient
ASA2
Mild to moderate systemic disturbance
ASA3
Severe systemic disturbance
ASA4
Life threatening disease
ASA5
Moribund patient
ASA6
Organ retrieval
When is a cardiac surgery of higher risk
High risk surgery, ischaemic heart disease, congestive heart failure, cerebrovascular disease, diabetes, renal failure
State the investigations conducted in Cardiovascular patients
ECG Exercise tolerance test Echo Myocardial perfusion scan Stress echo Cardiac catheterisation CT coronary angiogram
State the investigations conducted in Respiratory patients
Saturations ABG CXR Peak flow measurements FVC/FEV Gas transfer CT chest
State the conditions which should be aimed to be under optimal medical control before surgery
Hypertension Ischaemic heart disease Heart failure Asthma COPD Diabetes Epilepsy
State the medications which should be changed pre-op
Anti-diabetic medication and anticoagulatns
