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Flashcards in Principles of assessment Deck (15):
1

6 steps to come to diagnosis

-provisional diagnosis
-important aspects of history
-findings on examination
-results of investigation
-tissue diagnosis
-further investigations

2

5 steps once diagnosis is reached

-establish diagnosis
-exclude extent/ severity of disease
-evaluate whole system
-exclude external disease

3

what to consider for operation 5

-what is planned operation
-changes since op planned
-new diagnostic info
-special risks
-routine procedures eg bloods

4

ASA status types

-healthy
-mild systemic disease: no functional limitations
-severe systemic disease: definite functional limitation
-severe systemic disease that is a constant threat to life
-moribund pt not expected to survive 24 hrs with or without surgery

5

5qs for fitness of operation

-is pt fit for op
-incurrent diseases
-do these require invesigation
-does surgical condition give rise to problems eg fluids and electrolytes
-is pt taking drugs which could interfere with anaesthesia/ operation

6

7 common concurrent diseases

-ischaemic heart disease
-congestive heart failure
-arterial hypertension
-chronic resp disease
-diabetes mellitus
-cardiac arrythmias
-anaemia

7

3 aims of management

-diagnose pre-existing disease to make accurate assessment of degree of problem
-ensure pt medical condiiton is optimised before surgery
-consider drug interactions

8

6 high risk groups for perioperative complications

babies
over 60 yo
elderly
smokers
obese
intercurrent disease

9

how to manage babies 3

monitor fluids/ electrolytes
check drugs
heat loss

10

complications with
a. over 60s
b. elderly

a. cardiovascular disease --> chest x ray, pre op ECG, monitoring
b. elderly: confusion, hyponatraemia, immobility

11

2 risks of smokers and measures to control this

-post op chest infection/ atelectasis: stop smoking 4 weeks before op, pre op chest x ray, physio
-inc risk of myocardial infarction: pre op ECG, avoid hypoxia

12

2 consideratios of obese pts

increased risk of DVT
reduced mobility

13

considerations of after op

anticipate special probs eg living alone

14

9 essential preop assessment stages

history taking
physical exam
collate info about diagnosis
arrange for further investigation
discuss op, obtain consent
mark op site
inform theatre
prophylactic medication
plan rehab and convalescence

15

6 principles of assessment

-diagnosis
-operation
-anaesthesia
-fitness for operation
-high risk
-after operation