Preop Assessment

Question 1

Routine screening (ix)

Answer 1

Urinalysis: check blood glucose concentration if urine sugar is positive

FBC: All females, males > 40, all major surgery

BUSE: major surgery

ECG: age > 50y/o

CXR: age > 60y/o

Liver fx test: major surgery in pt > 50 y/o

Question 2

ASA classification
- indication
- classes

Answer 2

Indication: to assess pt pre anaest medical comorbidities

Class
I: normal healthy pt
II: pt with mild systemic ds
III: pt with moderate to severe systemic ds with some functional limitation but not incapacitated
IV: pt with incapacitating severe systemic ds which is a constant threat to life
V: moribund pt who is not expected to survive for 24h with or without surgery
E: pt undergo an emergency operation

Question 3

Indication to do ABG

Answer 3

• debilitated or septic pt
• moderate to severe pulmonary disease
• pt with respiratory difficulty
• morbidly obese pt
• pt scheduled for thoracotomy

Question 4

Aims of premed

Answer 4

• to reduce anxiety +/- produce amnesia
• reduce induction dose of anaes drug
• for prophylaxis against acid aspiration

Question 5

Types of premed

Answer 5

• oral benzodiazepines
• syrup medication (for paeds patients)
• antacids & H2 antagonist (for acid aspiration prophylaxis)

Question 6

Dont give sedative premed in;

Answer 6

• very young: preterm baby, young children < 6 months
• very old
• very ill
• most neurosurgical pt for craniotomy (unless fully conscious and very anxious)
• pt with potential airway difficulties
• obese +/- OSA
• pt for day care surgery (unless very anxious)