Transcript Preoperative evaluation of the patient

Preoperative evaluation of the
patient
Janusz Andres
Questions
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Describe anesthetic plan
ASA physical status scale
Preoperative evaluation
Routine preoperative laboratory evaluation
Physical examination
What is informed consent?
What kind of documentation is required?
Questions (2)
• Describe intraoperative anesthesia record
• What is PACU?
• Why the preoperative and postoperative
visits is so important?
• Quality of documentation
• What are four elements that must be proven
by the plaintiff?
Main purposes
• Medical history
• To choose the anesthestic and care plan
• To obtain informed consent
• To educate patient
• Cost-efficiency?
Medical problems
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Difficult airway
Asthma
Insulin-dependent diabetes mellitus
Drug abuse
Heart disease
Monoamine oxidase inhibitors
Pacemakers
Medical problems (2)
• Pacemakers or implantable defibrillators
• Peripheral motor neuropathy
• Pregnancy
• Pulmonary tuberculosis
• Renal insufficiency
Often asked questions
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When did you last have anesthesia?
Did you have problems with anesthesia?
Do you have allergies?
Did you have blood test last 6 months?
Did you have x-ray in the last 2 month?
Do you take any medications?
Did you have drinking problems?
Main problems
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Cardiovascular disease
Respiratory and airway problems
Hepatic and gastrointestinal disease
Bleeding problems
Renal disease
Endocrine disturbances
Neurologic disease
Physical examination
• Arterial blood pressure
• Chest auscultation
• Movement and neurological disorders
• Examinations of legs