Pre Op Care

Question 1

when should contraceptive pill be stopped before surgery

Answer 1

4 weeks before major/leg surgery, restart 2w after surgery

Question 2

when should contraceptive pill be stopped before surgery

Answer 2

4 weeks before major/leg surgery, restart 2w after surgery

Question 3

when should digoxin be stopped before surgery

Answer 3

continue up to and including morning of surgery

Question 4

how long NBM before surgery

Answer 4

2h for clear fluids, 6h for solids

Question 5

DVT prophylaxis

Answer 5

LMWH- enoxaparin 20mg/d start 2h pre op increase to 40 if major risk

Question 6

blood tests

Answer 6

U&E, FBC, finger prick glucose, crossmatch, group and save, specific tests

Question 7

what Hb should lead you to tell anaesthetist

Question 8

what specific blood tests can be done

Answer 8

LFT in jaundice, malignancy or alcohol abuse; amylase (acute abdomen), blood glucose, drug levels, clotting studies

Question 9

what should make you want to do clotting studies

Answer 9

liver or renal disease, DIC, drugs- valproate, warfarin, heparin

Question 10

investigations

Answer 10

CXR, ECG, echo, pu,monary function tests, MRSA screen

Question 11

what means that the patient has capacity

Answer 11

understand, retain, weigh the necessary information

Question 12

how is consent gained in the incapacitated

Answer 12

NHS consent form 4- noone can give consent on behalf of an adult, proceeding in the patients best interest is decided by clinician

Question 13

what % of GI surgery leads to infection

Answer 13

20% in elective, 60% in emergency

Question 14

is there any benefit from mechanical bowel cleansing before open colonic surgery

Answer 14

no

Question 15

is there any benefit from mechanical bowel cleansing before open colonic surgery

Answer 15

no

Question 16

when should digoxin be stopped before surgery

Answer 16

continue up to and including morning of surgery

Question 17

how long NBM before surgery

Answer 17

2h for clear fluids, 6h for solids

Question 18

DVT prophylaxis

Answer 18

LMWH- enoxaparin 20mg/d start 2h pre op increase to 40 if major risk

Question 19

blood tests

Answer 19

U&E, FBC, finger prick glucose, crossmatch, group and save, specific tests

Question 20

what Hb should lead you to tell anaesthetist

Question 21

what specific blood tests can be done

Answer 21

LFT in jaundice, malignancy or alcohol abuse; amylase (acute abdomen), blood glucose, drug levels, clotting studies

Question 22

what should make you want to do clotting studies

Answer 22

liver or renal disease, DIC, drugs- valproate, warfarin, heparin

Question 23

investigations

Answer 23

CXR, ECG, echo, pu,monary function tests, MRSA screen

Question 24

what means that the patient has capacity

Answer 24

understand, retain, weigh the necessary information

Question 25

how is consent gained in the incapacitated

Answer 25

NHS consent form 4- noone can give consent on behalf of an adult, proceeding in the patients best interest is decided by clinician

Question 26

what % of GI surgery leads to infection

Answer 26

20% in elective, 60% in emergency

Question 27

when are prophylactic antibiotics given

Answer 27

IV- 30 min prior to surgery, metronidazole PR is 2h

Question 28

is there any benefit from mechanical bowel cleansing before open colonic surgery

Answer 28

no

Question 29

benefits of drain insertion post op

Answer 29

protect against collection, haematoma, seroma formation