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Flashcards in MISC - Preoperative assessment Deck (7)
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Purpose of preoperative assessment

•Assess fitness
•Assess medical and surgical conditions
•Identify risks & reduce morbidity
•Explain & Consent


Hx in preop assessment

•Presenting complaint
–Emergency or elective
•Past history
•Family history
•Social history
•Systems review – check the questionnaire
•Fasting status


What questions would you ask to assess the functional capacity that is greater than 4 METS?

- climb 2 flights of stairs or walk uphill?
- run a short distance?
- do heavy work around the house like scrubbing floors/lifting/moving heavy furniture?
- participate in strenous sports like swimming etc?


Examination in pre-op assessment

•Vital signs
•ABCDE (in an emergency)
•Related to the surgical pathology
•Cardiovascular - VEINS
•Respiratory - AIRWAY
•Nervous system – BLOCK SITE


Ix of preop assessment

UEC, FBE, LFT, BGL (+HbA1C for diabetics), ECG, RFT, ECHO, Sleep studies

**Routine investigations are not necessary in those who are fit and young, undergoing routine surgery

Patients with pre-existing medical conditions should have investigations relevant to their illness

Group and screen is required for operations where major blood loss is expected.


Minor & major Risks of anaesthesia

–Failed iv access
–Cut lip, dental injury, sore throat

–Aspiration of gastric content
–Hypoxic brain injury
–MI, Stroke
–Nerve injury
–Chest infection


Pre-medication in anaesthetics

•Antacid prophylaxis
•Medications to control a pre-existing medical condition (anti-anginals, antihypertensives, bronchodilators)

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