preoperative evaluation: A time-saving algorithm By - Michael J. Arnold
What is a preoperative evaluation?
Preoperative evaluation means the clinical investigation that precedes anesthesia before any surgical intervention. It includes history and physical examination with an emphasis on risk factors for heart, lung, and infectious complications, and an assessment of the patient's functional performance is essential for preoperative evaluation. Careful medical history and physical examination are the most important factors in preoperative lung risk assessment.
The motive of preoperative assessment is not to "release" patients for elective surgery, but to evaluate and take action to prepare high-risk patients for surgery. Preoperative outpatient care evaluation can reduce hospital stays and minimize postponement or cancellation of surgery.
How will you be proceeding with preoperative evaluation?
•Patient ID: The nurse will ask for your name and date of birth, check your ID and compare it to your record.
•Medical history and physical examination: Medical history must include past and present medical history, surgical history, and family history.
• Sample of blood
• X-ray of chest and other indicated scans
• Consultation for anesthesia
• Nurse consultation
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Why is a preoperative evaluation done?
The ultimate goal of preoperative medical evaluation is for the patient.
It is to shorten the operation period and the anesthesia period, morbidity or mortality, and return to the desired function as soon as possible.
Careful preoperative evaluation is essential for good surgical results. Also, helps to decide the benefits of surgery vs no surgery vs no treatment. Decisions about a patient's surgical ability are usually made weeks before surgery. But the evaluation is modified in case of emergency surgery when the decision is to be taken in a short period of time.
The main purposes of preoperative evaluation are as follows.
● Documentation of conditions requiring surgery.
● Assessment of the patient's general health.
● Reveal hidden conditions that can cause problems both during and after surgery.
● Determines the perioperative risk.
● It optimizes the patient's condition and reduces the patient's peri-operative morbidity or mortality from surgery and anesthesia.
● Creating a relevant per-operative care plan.
● Educate patients on surgery, anesthesia, intra-operative care, and
postoperative pain management in the hope of reducing anxiety and promoting recovery.
● Reduce costs, reduce hospitalizations, reduce cancellations, and improve patient satisfaction.
How is a preoperative evaluation done?
Preoperative preparations for patients include:
Medical records and bodily examination
These are carried out and documented via a health practitioner or a registered nurse. Allergies must be noted. The preoperative nurse establishes the baseline for the affected person`s critical signs.
Lab Tests
Chest x-ray
Electrocardiogram (ECG)
Diagnostic procedures
Written commands and consent
References:
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