Preoperative Assessment

Question 1

Goals for Preoperative assessment

Answer 1

• optimize patient
• build rapport
• identify Comorbidities and treat
• medications
• risk prediction
• anaesthestic plan discussion
• informed consent
• preventing cancellation of surgery

Question 2

History in Preoperative

Answer 2

Identification
Surgery details. (Nature, location, sides)
Hx of previous surgery and anaesthesia (types, any reactions or difficulty intubating , ifficult IV access or post op complications , delayed recovery )
Hx of allergies
Past medical history for Comorbidities (cvs dx, respi dx, diabetes, SCD, epilepsy, etc)
Lifestyle - alcohol , smoking
Blood transfusion consent

Question 3

Physical exam component

Answer 3

General
Cardiorespiratory exam
Airway assessment

Question 4

Key investigations

Answer 4

FBC
Clotting profile (if indicated)
BUE and creat
Cardiac - ECG CXR echo ( if indicated)
Respi PFTs ( if indicated)

Question 5

Airway assessment history

Answer 5

Previous difficult intubation
Congenital abnormalities (DS, pierre robin syndrome..)
Obstructive symptoms (dyspnea, dysphasia, snoring etc)
Diabetes, pregnancy , RA
Hx of radiotherapy or surgery in airways
Mass or tumors Rand airway

Question 6

Airway assessment examination

Answer 6

Obesity
Cant do prayer sign for joint abnormalities
Tracheal deviation
Mouth (dentition, large tongue, inter incisor gap <3cm, mallampati grade iii or IV)
Neck (mass, thromental distance <6cm, sternomental <12.5)

Question 7

Fasting guidelines (2-4-6-8 rule)

Answer 7

8h- fatty/heavymeal
6h -infant formula, light meal
4h- breastfeeding
2h- clear fluids.