ASA grade 1
ASA grade 2
ASA grade 3
ASA grade 4
ASA grade 5
ASA grade 6
ASA grade E
What scale is used to classify the complexity of surgery?
The four-point scale (NICE)
What is the test sensitivity?
The sensitivity of the test is the proportion of diseased patients who have a positive test result
What is the test's specificity?
The specificity of the test is the proportion of healthy patients who have a normal test result
What is Positive Predictive Value (PPV)?
The positive predictive value (PPV) is the likelihood of a patient with a positive result having disease
What is the Negative Predictive Value (NPV)?
The negative predictive value (NPV) is the likelihood of a patient with a normal result not having disease
What factors do recommendations for preoperative tests depend on?
- whether the patient has systemic disease
What are the criteria for ordering peri-operative tests?
Who do we offer Sickle-cell test to? (peri-operatively)
Sickle cell tests should be offered to anyone with:
- a family history of homzygous disease or heterozygous trait
- African or Afro-Caribbean ancestry; Asian ancestry; Middle-Eastern ancestry; East-Mediterranean ancestry (including Cyprus).
Who do we offer pregnancy test to (preoperatively)?
Any woman who says she may be pregnant
What are examples of indications to order FBC (pre-operatively)?
What are examples of indications to order CXR (pre-operatively)?
Recent respiratory illness which is still symptomatic
What are examples of indications to order FBC and coagulation screen (pre-operatively)?
History of prolonged bleeding
What are examples of indications to order ECG (pre-operatively)?
History of palpitations
What are examples of indications to order respiratory function tests and ABGs (pre-operatively)?
severe respiratory disease
What are examples of indications to order ECHO (pre-operatively)?
in undiagnosed murmur
Why do we do cardiopulmonary exercise testing (CPX)?
What does it measure?
Major surgery puts the major stress on a body
- It is a non-invasive procedure that involves progressively raising the level of exercise whilst monitoring the body’s metabolic state
- to assess the extent to which oxygen delivery can be increased to meet the tissue needs
- An important measure is the anaerobic threshold - the point at which oxygen delivery is no longer adequate and anaerobic metabolism starts.