Flashcards in MISC - Preoperative assessment Deck (7)
Purpose of preoperative assessment
•Assess medical and surgical conditions
•Identify risks & reduce morbidity
•Explain & Consent
Hx in preop assessment
–Emergency or elective
•Systems review – check the questionnaire
•FUNCTIONAL STATE (>4 METS)
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
•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