preoperative_flashcards_brainscape
What does the acronym ‘RAPRIOP’ stand for in pre-operative management?
Reassurance, Advice, Prescription, Referral, Investigations, Observations, Patient understanding and follow-up.
How can a junior doctor reassure a pre-operative patient?
Recognize their anxiety and offer kind, reassuring words about the upcoming procedure.
What is the typical pre-operative fasting regime?
No food for 6 hours before surgery, with clear fluids allowed up to 2 hours before surgery.
Why is fasting important before surgery?
Fasting ensures the stomach is empty, reducing the risk of aspiration pneumonitis or pneumonia.
What is the mnemonic to remember commonly stopped medications before surgery?
CHOW - Clopidogrel, Hypoglycaemics, Oral contraceptive pill (OCP)/Hormone Replacement Therapy (HRT), Warfarin.
Why is Clopidogrel stopped 7 days prior to surgery?
Due to the increased risk of bleeding during surgery.
What should be done if a patient’s INR is still high before surgery?
Reverse the warfarinization with PO Vitamin K if the INR remains high.
How is subcutaneous insulin managed in the pre-operative period?
It may be switched to a variable rate intravenous insulin infusion (VRIII).
What is the conversion rate for oral prednisolone to IV hydrocortisone?
5 mg PO prednisolone = 20 mg IV hydrocortisone.
When should patients be prescribed anti-embolic stockings?
All patients should be prescribed below knee anti-embolic stockings unless contraindicated.
What prophylaxis is often required for orthopedic, vascular, or gastrointestinal surgeries?
Prophylactic antibiotics as per the procedure and surgeon preference.
How are diabetic patients managed perioperatively?
Diabetic patients should be first on the list, have blood glucose monitored regularly, and may need a sliding scale insulin infusion.
What type of bowel preparation is required for a left hemi-colectomy?
Phosphate enema on the morning of surgery.
What is essential for patients undergoing major GI, vascular, or orthopedic surgery regarding blood products?
Ensure a group and save is requested, and cross-matching may be needed.
Why might a patient need a referral to HDU or ITU pre-operatively?
If the patient is at high risk or has comorbidities requiring closer postoperative monitoring.
