preop may2014 handout

1 Pre-operative evaluation Chutintorn Sriphrapradang, MD 29 May 2014 !"#$#%&' ()* • +," elective $-. % emergency • Indication ? • +," //#)"%), "01- !"#23145 6(7/89:;-79<= )3 ! !"#$"%&'() *, +,- ./?, 0#.12 $)34/(5671./? ! Focused review " !"#4) *8&/$57, functional status " 09:5755;<= /., >? @@ 4"2 /7: 1049- / ! Vital signs, weight, height ! Cardiac and pulmonary exam. ! Anatomical conditions " Airway examinatio n >"-?%< consult ! ?-:@A%<B-7:' ?C ?-:@-,"0>") /5 :)?39%09A#% ! ?%<D$5 ;' /9@3 ?-0@E / 945 "D@0, ") A F"G $(' >: ;">"- ! #= plan " Anticipate problems & questions ! ?C/?, %1/5 ! Talk is cheap and effective. " Direct verbal communication ! Consult, don't insult ! ! Follow recommendation Perioperative Cardiovascular Evaluation for Noncardiac Surgery • ACC/AHA 2007 Guideline on Perioperative CV Evaluation and Care for Noncardiac Surgery • ACC/AHA 2009 Focused Update on Perioperative Beta-Blocker Therapy American College of Cardiology - www.acc.org American Heart Association -www .americanheart.org Preoperative Clinical Evaluation • Identification of potentially serious cardiac disorders • Evaluate severity, stability, and cardiac disorders – CAD eg prior MI, angina – HF – Significant arrhythmia – Severe valvular disease • Other factor to determine cardiac risk – Functional capacity – Age – Comorbid conditions eg DM, PVD, CKD, COPD – Type of surgery

preop may2014 handout

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