Beruflich Dokumente
Kultur Dokumente
AND PREPARATION
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Anesthesiology
Cutting Medical
specialties specialties
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The purpose of preoperative evaluation is not to give
medical clearance, but rather to perform an evaluation
of the patients current medical status; make
recommendations concerning the evaluation,
management, and risk of cardiac problems over the
entire perioperative period; and provide a clinical risk
profile that the patient, primary physician,
anesthesiologist, and surgeon can use in making
treatment decisions
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Preoperative anesthetic
evaluation
1. Identification of disease
2. Assessment of the severity of the underlying
disesase
3. Medical optimization or treatment of
identified disease
4. Assessment of preoperative anesthetic risk
5. Plan of anesthetic management
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What are You Really Being
Asked to Do?
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Pre-anaesthetic evaluation
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Pre-anaesthetic evaluation
The plan
If airway management
best combination and is deemed difficult,
drugs and dosages and then alternative
the degree of how fasting time placement methods
much monitoring is such as fiberoptic
required . intubation may be
used.
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Preoperative Evaluation
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1.Review of patient data
Medical record
Interview history
History of underlying disease,
medication,
functional capacitance,
previous anesthetic history,
family history,
smoking and alcoholic use,
review of system,
psychological support
Airway evaluation
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2. Physical examination
Vital signs
General appearance
HEENT
Respiratory system
CVS system
Abdomen
Extremities and spine
Neurologic system
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Airway evaluation
History of difficult intubation
Head and neck examination for airway
evaluation
Face
Oral cavity : mouth opening
mandibular space
tongue
teeth
Mallampati classification
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Predictors of difficult intubation ( 4 M )
M allampati
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Measurements 3-3-2-1
3 Fingers Mouth Opening
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Malformation of the skull
Skull (Hydro and Microcephalus)
Treacher Collins
(mandibulofacial
dysostosis)
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Goldenhar's
(oculoauriculovertebral dysplasia)
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ASA Physical Status Classification System
For emergent operations, you have to add the letter E after the classification.
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Fasting Recommendations
Breast milk 4
Infant formula 6
Nonhuman milk 6
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Plan of Anesthetic Technique
1. Is the patient's condition optimal?
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