Pre-operative Assessment Flashcards
What are the components of the pre-operative assessment?
Hx
Ex
Ix
Management Plan
Content
Prescription
What systems/conditions must you specifically ask about for pre-operative Hx?
Cardiovascular
Respiratory
Rheumatoid
Renal
Liver
Neurological
Diabetes
What exercise tolerance must a patient have to be fit for surgery?
4 mets > equivalent to climbing a flight of stairs, doing housework
What is the name of the functional state scoring system?
ASA - American Society of Anaesthesiologists
What is the mortality of someone with a ASA score of 5?
9.4%
How do you examine the airways?
Mouth opening
Teeth
Cervical spine motion
Temporomandibular joint function
Mallampati classification
Thyromental distance
Do you perform Ix on healthy fit patients?
No, only unwell ones
Which types of anaesthetics require airway management?
GA
Sedation
What are some major complications of anaesthetics?
Aspiration of gut contents
Hypoxic brain injury
MI, Stroke
Nerve injury
Chest infection
Death
How can you prevent gastric aspiration?
Prophylatic anti-emetic - 20mg of maxalon
What are the anaesthetic options for a hip replacement?
GA
Sedation with fascia block
Spinal nerve block
Epidural
How can you reduce the risk of aspiration of gastric contents?
Fasting
Lie the patient on an incline
Prophylactic metoclopramide
Put pressure on the cricoid cartilage to occlude the oesophagus
Enter the tube quickly
What do you do for a warfarin patient in pre for surgery?
Replace their warfarin with clexane in the 5 days leading up to surgery (warfarin takes 5 days to be removed)
