Preanes assess

Question 1

Pre-Anesthesia Interview goals

Answer 1

Learn of the patient’s procedure and medical history
Establish a Provider-Patient relationship
Develop an anesthesia plan
Provide patient education and direction
Obtain an informed consent.

Question 2

Cardiac ROS

Answer 2

Exercise tolerance
HTN
Vascular Disease
CAD
Previous MI
Dysrrhythmias

Question 3

Respiratory ROS

Answer 3

Exercise tolerance
Smoking history
Asthma, Seasonal allergies
OSA
CPAP compliant or non-compliant
COPD (Emphysema/Bronchitis)

Question 4

Renal ROS

Answer 4

Renal insufficiency
ESRD
Need for dialysis

Question 5

Hepatic & Endocrine ROS

Answer 5

Hepatic (ETOH, Hepatitis, Cirrhosis)

Endocrine (DM, Thyroid disorders)

Question 6

Neuro ROS

Answer 6

Seizures
CVA/TIA
Neuropathies

Question 7

NPO status

Answer 7

Clear liquids-2 hours
Breast Milk-4 hours
Infant formula-6 hours
Nonhuman Milk-6 hours
Light meal-6 hours

Question 8

Rule of Threes

Answer 8

Acute History
-Exercise Tolerance
-Hx present illness & treatments
-Last visit with PCP
Chronic History
-Medications & Allergies
-Social History: ETOH, Tobacco
-Family Hx, PMH, PSH
Physical Examination
-Airway
-Cardiovascular
-Lung

Question 9

ASA 1

Answer 9

A normal healthy patient

Question 10

ASA 2

Answer 10

A patient with mild systemic disease (mild diabetes, controlled hypertension, obesity)

Question 11

ASA 3

Answer 11

A patient with severe systemic disease that limits activity (angina, COPD, prior MI)

Question 12

ASA 4

Answer 12

A patient with severe systemic (incapacitating) disease that is a constant threat to life (CHF, renal failure)

Question 13

ASA 5

Answer 13

A moribund patient who is not expected to survive without the operation (ruptured aneurysm)

Question 14

ASA 6

Answer 14

A declared brain-dead patient whose organs are being removed for donor purposes

Question 15

STOP BANG

Answer 15

Assess risk for OSA
1. SnoringDo you snore loudly (louder than talking or loud enough to be heard through closed doors)?
2. TiredDo you often feel tired, fatigued, or sleepy during daytime?
3. ObservedHas anyone observed you stop breathing during your sleep?
4. Blood pressureDo you have or are you being treated for high blood pressure?
5. BMIBMI more than 35 kg/m2?
6. AgeAge over 50 yr old?
7. Neck circumferenceNeck circumference greater than 40 cm?
8. GenderGender male?
* Neck circumference is measured by staff
High risk of OSA: answering yes to three or more items
Low risk of OSA: answering yes to less than three items