General Preoperative Assessment

2025-02-24T23:21:26Z

GiftyAgyemang:

==== Introduction ====
The preoperative assessment is the first step in providing effective anesthesia for a patient. It is a process by which the anesthesia provider intentionally evaluates their patient and creates a plan to safely conduct anesthetic care. As many surgeries are becoming outpatient cases, the preoperative assessment is often done on the day of surgery, however, depending on the patient and their comorbidities, the nature of the surgery, and the institution providing care, this assessment can also be done further in advance in a preoperative clinic setting. The major goals of the preoperative assessment are to build rapport with the patient and their support person(s), ensure the patient is medically fit for surgery, perform a physical exam including airway exam, educate on the risks and benefits of the anesthetic plan, determine the need for any special monitors, lab work or medications, and obtain informed consent.

==== Chart Review ====

==== History and Physical ====
Obtaining a focused yet thorough patient history is a hallmark of the preoperative assessment. History often includes:

# Medical history and comorbidities (include gestational age, complications at birth/NICU admission)
# Family history of complications with anesthetics (i.e. malignant hyperthermia, pseudocholinesterase deficiency)
# Indications for the surgery
# NPO status
# History of previous anesthetics and any known complications (i.e. difficult airway, PONV, intraoperative complications)
# History of current/recent upper respiratory tract infections
# Any known allergies
# Medications
# Review of systems

Medical History - obvious reasons

Family History - important to ask as many first anesthetic for most

Indication for surgery - positioning

NPO status - insert NPO time table. important for decreasing aspiration risk

Prev anes- guide your current plan

URI - case cancellation, laryngospasm risk

Allergies- how food allergies can suggest propofol or latex allergy

Meds - drug interactions

ROS - insert another table

==== Pre-operative Labs ====

==== Pre-operative Imaging ====

==== ASA Physical Status Classification ====
{{Stub Notice}}

[https://viaaerearcp.files.wordpress.com/2020/02/evaluacion-preanestesica2018.pdf Preoperative anesthesia evaluation]

[https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system Statement on ASA Physical Status Classification System]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.12052 Paediatric emergencies]

[https://pubmed.ncbi.nlm.nih.gov/31219919/ One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients]

[https://pubmed.ncbi.nlm.nih.gov/32665468/ The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study]

General Preoperative Assessment

2025-02-24T19:51:26Z

GiftyAgyemang: Started giving details on the preoperative assessment

==== Introduction ====
The preoperative assessment is the first step in providing effective anesthesia for a patient. It is a process by which the anesthesia provider intentionally evaluates their patient and creates a plan to safely conduct anesthetic care. As many surgeries are becoming outpatient cases, the preoperative assessment is often done on the day of surgery, however, depending on the patient and their comorbidities, the nature of the surgery, and the institution providing care, this assessment can also be done further in advance in a preoperative clinic setting. The major goals of the preoperative assessment are to build rapport with the patient and their support person(s), ensure the patient is medically fit for surgery, perform a physical exam including airway exam, educate on the risks and benefits of the anesthetic plan, determine the need for any special monitors, lab work or medications, and obtain informed consent.

==== Chart Review ====

==== History and Physical ====
Obtaining a focused yet thorough patient history is a hallmark of the preoperative assessment. History often includes:

# Medical history and comorbidities
# Indications for the surgery
# NPO status
# History of previous anesthetics and any known complications (i.e. difficult airway, PONV, intraoperative complications)

==== Pre-operative Labs ====

==== Pre-operative Imaging ====

==== ASA Physical Status Classification ====
{{Stub Notice}}

[https://viaaerearcp.files.wordpress.com/2020/02/evaluacion-preanestesica2018.pdf Preoperative anesthesia evaluation]

[https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system Statement on ASA Physical Status Classification System]

[https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.12052 Paediatric emergencies]

Ferrari LR, Leahy I, Staffa SJ, Johnson C, Crofton C, Methot C, Berry JG. One Size Does Not Fit All: A Perspective on the American Society of Anesthesiologists Physical Status Classification for Pediatric Patients. Anesth Analg. 2020 Jun;130(6):1685-1692. PMID: 31219919

Ferrari L, Leahy I, Staffa SJ, Berry JG. The Pediatric-Specific American Society of Anesthesiologists Physical Status Score: A Multicenter Study. Anesth Analg. 2021 Mar 1;132(3):807-817. PMID: 32665468

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General Preoperative Assessment

General Preoperative Assessment