Anesthesia Lab II: Lecture 2 - PreOp Eval Flashcards
Why is the preoperative interview important?
It establishes trust, gathers crucial history, and helps customize the anesthetic plan.
How can we help make the patient more comfortable preoperatively?
By communicating clearly, respectfully, and confidently—our presence is a powerful ‘drug’.
What should you review before seeing the patient?
Surgical procedure, surgeon preferences, patient chart, medication list, prior surgeries, labs, pregnancy test.
Why is reviewing the medication list early important?
It can reveal underlying conditions and helps tailor anesthesia care.
What key questions should you ask about prior anesthesia?
Type of anesthesia, complications like MH, prolonged intubation, or PONV.
What family history is important for anesthesia?
History of malignant hyperthermia or other anesthesia reactions.
What allergies are red flags for anesthesia?
Anaphylaxis, latex allergy (fruit allergy), iodine allergy (shellfish), and antibiotic reactions (penicillin means NO Ancef)
Why should tape allergies be noted?
To ensure proper selection of surgical tape and eye protection.
How is fluid deficit calculated?
Hourly requirement (kg + 40) × hours NPO.
Why ask detailed questions about recent food intake?
Patients may forget or misrepresent their fasting status.
What meds should usually be continued preoperatively?
Beta blockers.
Which medications should be stopped before surgery?
ACE inhibitors, ARBs, diuretics, diabetes meds, anticoagulants (based on timing).
Xarelto = 24 hours before
Eliquis = 48 hours before
Coumadin = 5-7 days before
Aspirin and/or Plavix = 7-10 days before
What social habits are important to ask about preoperatively?
Alcohol, tobacco, and illicit drug use.
Why ask about drug use privately?
To encourage honesty and ensure safe anesthesia care.
How is functional status assessed?
By estimating METs through questions about daily activities.
1 MET is 3.5 mL O2/kg/min
What MET level indicates good functional status?
4 METs or greater.
What systems should be reviewed preoperatively?
Neurological, endocrine, respiratory, cardiovascular, GI, urinary, musculoskeletal, hepatic, renal, reproductive.
Why use simple language in the ROS?
To ensure patient understanding and accurate history taking.
What questions should be asked about neurological history?
Seizures, strokes, medications, triggers, and neurologist follow-up.
What endocrine conditions should be assessed preop?
Diabetes, thyroid disease, adrenal disorders.
Why is prior neck radiation relevant?
It may alter airway anatomy and affect intubation.
What are important respiratory questions?
Asthma, COPD, O2 use, triggers, inhaler use, CPAP use.
What cardiovascular history is important preoperatively?
HTN, MI, arrhythmias, medications, last cardiology visit.
What should patients >50 years old receive preoperatively?
An EKG, even without cardiac history.
