Pre/Peri/Post Op Care and Monitoring

Question 1

Pre-op consent

Answer 1

Informed consent for all procedures
In writing
Reconfirm on day
Assess capacity to consent
Assess IV access

Question 2

Pre-op instructions

Answer 2

Fasting, escort
Assess ASA
Allergies, drug hx, FH, SH

Question 3

ASA I

Answer 3

Healthy patient - non smoker, min alcohol

Question 4

ASA II

Answer 4

Mild-moderate systemic disease e.g. controlled asthma, DM, HTN, smoking

Question 5

ASA III

Answer 5

Severe systemic disease e.g. uncontrolled DM/HTN, CV disease, BMI > 40

Question 6

ASA IV

Answer 6

Severe systemic disease that is a constant threat to life e.g. recent MI, CVA, TIA, RD without dialysis

Question 7

ASA V

Answer 7

Moribund patient with limited survival expectancy e.g. intracranial trauma, multiple organ failure

Question 8

ASA VI

Answer 8

Declared brain-dead patient, organs for transplant

Question 9

Complications of conscious sedation

Answer 9

1) Ineffective ventilation
2) CVS/Hypotension
3) Drug overdose or hypersensitivity reaction
4) Aspiration
5) Nausea and vomiting
6) Equipment issues

Question 10

Peri-operative monitoring by

Answer 10

Qualified person(s)
Regular audit

Question 11

Monitoring of clinical signs includes

Answer 11

BP
PPO2
HR
Airway, depth of resp, colour
Level of sedation
Oxygen saturation should be 90%+

Question 12

Sedation related medical emergencies:
If concerns arise

Answer 12

Carry out ABCDE
Stop procedure
Provide O2/emergency drugs
Consider reversal agent

Question 13

Higher risk patients

Answer 13

Anxious
Uncooperative
Extreme age
CVS/hepatic/renal/CNS issues
Obstructive airway
Pregnant
History of drug/alcohol abuse