perio 3

Question 1

Preoperative Assessment:

What is it & Why

Answer 1

• Clinical investigation that precedes anaesthesia
• Undertaken in pre-admission clinic/telephone
• Enables opportunity to manage co-morbidities
• Provides quality safe perioperative care and reduce
  cancellations

Question 2

Preoperative Assessment:

How…

Answer 2

• Medical history (surgical history, family history, comorbidities,
  medications, allergies, prosthesis/pace-makers etc)
• Age, weight and height
• Baseline observations
• Current medications (including herbal i.e. fish oils and
  recreational) may need to be ceased prior to surgery
• Anaesthetic evaluation (difficult airway, MH, PONV)
• May include further investigations (X-rays, ECGs, Blood
  investigation)

Question 3

ASA Grade:

Answer 3

ASA I - 
ASA II -
ASA III -
ASA IV - 
ASA V -

Question 4

ASA I

Answer 4

Normal healthy patient

Question 5

ASA II

Answer 5

Patient with mild disease (i.e. current smoker, pregnancy,

obesity, controlled DM/HTN)

Question 6

ASA III -

Answer 6

Patient with severe systemic disease (i.e. BMI >40,

COPD, implanted pacemaker)

Question 7

ASA IV -

Answer 7

Patient with severe systemic disease that is a constant
threat to life (i.e reduction in ejection fraction, sepsis, cardiac
ischemia)

Question 8

ASA V

Answer 8

A moribund patient who is not expected to survive

without the operation (i.e. Ruptured AAA, massive trauma)

Question 9

Preoperative Checklist

Answer 9

• Patient Identification (Name, DOB, MRN)
• Consent (must have the patient state surgery)
• Allergies and Sensitivities
• Preoperative fasting
• Premedication and medications
• Dentures/caps/crowns/loose teeth
• Implants (pacemakers, joint replacements, etc)
• Jewelry and piercings
• Belongings (bags, glasses, hearing aids

Question 10

Preoperative Fasting:

Answer 10

• Reduce risk of aspiration of stomach contents (potentially fatal)
• Body fluid depletion due to excessive fasting can cause
  dehydration, electrolyte imbalance, headaches, malaise

Question 11

ASA recommendations: for fasting

Answer 11

• 6 hours for food
• 2 hours for clear fluids (water, apple juice)
• 4 hours breast milk