Pre-Operative Evaluation (Exam I) Flashcards
What is the (metric) formula for BMI?
BMI = kg / m²
What is the (imperial) formula for BMI?
(703 · BW-lbs) ÷ (inches²)
What mnemonic guides an emergent physical examination?
AMPLE
- Allergies
- Medications
- Past medical history
- Last meal
- Events leading up to need for surgery
What factors are worth one point on the Revised Cardiac Risk Index?
- High risk surgery
- Ischemic heart disease
- Hx of CHF
- Hx of CVA
- DM w/ insulin
- Creatinine > 2 mg/dL
What group of surgeries has the highest risk?
Vascular (Aortic, major, & peripheral vascular) > 5%
What sort of risk would be seen on the Revised Cardiac Risk Index with a score of 0?
What about with a score of 3 or greater?
- 0 = 0.4%
- 3 = 5.4%
What are METs?
What is one MET equal to?
- Metabolic Equivalent of Tasks (measurement of rate of energy consumption).
- 1 MET = 3.5 mLO₂ /kg/min
How would one assess functional capacity? What is the range of this assessment?
- Through METs
- 1 MET = eating, working at computer, etc
- 12 MET = running rapidly for long distances
What are the three levels of urgency of surgery?
- Emergent - Life or limb threatened, sx needed within 6 hours, no cardiac pre-op necessary.
- Urgent - Life or limb threatened, sx needed in 6-24 hours.
- Time-sensitive - delays exceeding 1-6 weeks would adversely affect patient.
What ASA level would an otherwise healthy 22 year old who got in a car wreck with massive trauma necessitating emergent surgery have?
- ASA V (won’t live without sx)
What ASA level would a healthy non-smoking 27 year old with diabetes have coming in for an EGD?
- ASA II (healthy but has well-controlled DM)
What ASA level would a 56 year old male who had an MI 2 months ago have for his follow up TEE today?
- ASA IV (MI less than 3 months ago)
What ASA level would a 12 year old girl with no hx have coming in for a routine tonscillectomy?
- ASA I (no hx, healthy, routine sx)
What ASA level would a 42 year old male with COPD and poorly controlled DM have?
- ASA III (COPD, poorly controlled DM)
What is the most common anaphylactic drug allergy?
What other two drugs have really common allergies?
- NMBs
- Antibiotics & chlorhexidine
What condition makes one more prone to latex allergy?
- Spina Bifida
What three things discussed in lecture would prompt you to order coagulation studies?
- Known or suspected coagulopathy
- Known bleeding disorder, hepatic disease, or anticoagulant use.
- ASA 3-4; undergoing moderate - major surgery