MISC - Preoperative assessment Flashcards
1
Q
Purpose of preoperative assessment
A
•Assess fitness •Assess medical and surgical conditions •Identify risks & reduce morbidity –Patient –Surgery –Anaesthesia •Plan •Explain & Consent
2
Q
Hx in preop assessment
A
•Presenting complaint –Emergency or elective •Past history •Family history •Medications •Social history •Allergies •Systems review – check the questionnaire •FUNCTIONAL STATE (>4 METS) •Fasting status
3
Q
What questions would you ask to assess the functional capacity that is greater than 4 METS?
A
- 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?
4
Q
Examination in pre-op assessment
A
- Vital signs
- ABCDE (in an emergency)
- Related to the surgical pathology
- Cardiovascular - VEINS
- Respiratory - AIRWAY
- Nervous system – BLOCK SITE
5
Q
Ix of preop assessment
A
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.
6
Q
Minor & major Risks of anaesthesia
A
•Minor –Failed iv access –Cut lip, dental injury, sore throat –Headache –PONV
•Major –Aspiration of gastric content –Hypoxic brain injury –MI, Stroke –Nerve injury –Chest infection –Death
7
Q
Pre-medication in anaesthetics
A
- Anxiolysis
- Amnesia
- Analgesia
- Antacid prophylaxis
- Antisialagogue
- Medications to control a pre-existing medical condition (anti-anginals, antihypertensives, bronchodilators)
