MISC - Preoperative assessment Flashcards Preview

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Flashcards in MISC - Preoperative assessment Deck (7)
1

Purpose of preoperative assessment

•Assess fitness
•Assess medical and surgical conditions
•Identify risks & reduce morbidity
–Patient
–Surgery
–Anaesthesia
•Plan
•Explain & Consent

2

Hx in preop assessment

•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

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?

4

Examination in pre-op assessment

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

5

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.

6

Minor & major Risks of anaesthesia

•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

Pre-medication in anaesthetics

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

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