21 Preoperative care including the high-risk surgi

ARRANGING AN ELECTIVE THEATRE LIST The date, place and time of operation should be matched with ...

ASSESSMENT OF RISK Despite more comorbid patients presenting for surgery , the perioperative mort...

Airway assessment The di ffi culty encountered when performing airway manoeu - vres, i.e. hand vent...

COMMON PREOPERATIVE PROBLEMS AND MANAGEMENT Specific medical problems encountered during preoper...

CONSENT Consent is a key part of preoperative care. The process of consent has evolved over the ...

Cardiopulmonary exercise testing CPET is the gold standard measurement of a patient’s fitness. The...

Cardiovascular disease Perioperative cardiovascular complications are frequent. Patients who can ...

Cerebral vascular disease Patients who have su ff ered a cerebrovascular accident have been shown ...

Choosing the right operation for the high-risk patient There are situations in which the selectio...

Drug-eluting coronary stents (DES) Primary percutaneous intervention is the treatment of choice ...

Dysrhythmias In patients with atrial fibrillation (AF), β -blockers, digoxin or calcium channel bl...

EMERGENCY SURGERY In emergency surgery the principles of preoperative assessment should be the s...

Endocrine and metabolic disorders Malnutrition Body mass index (BMI) is weight in kilograms divid...

Examination Patients should be treated with respect and dignity , receive a clear explanation of ...

FURTHER READING Bainbridge D, Martin J, Arango M, Cheng D; for the Evidence-based Peri-operative ...

Factors contributing to risk Risk is a complex interaction of multiple factors that can be class...

Gastrointestinal disease Regurgitation risk Patients undergoing general anaesthesia or sedation h...

Genitourinary disease Renal failure Underlying conditions leading to chronic renal failure such a...

Heart failure Left ventricular failure is the end result of several conditions, including IHD, h...

Hypertension Prior to elective surgery blood pressure should be controlled to <160/100 /uni00A0 m...

Implanted pacemakers and cardiac defibrillators Checks and appropriate reprogramming should be don...

INTRODUCTION The stress of major surgery can lead to increased oxygen demand by up to 40%. Inflam...

Investigations Guidelines produced by the UK’s National Institute for Health and Care Excellence ...

Ischaemic heart disease Patients with angina that is not well controlled should be inves - tigate...

Learning objectives To understand preoperative preparation for surgery: Surgical, medical and ana...

Musculoskeletal disorders Muscular disorders have serious implications and require a tailored ana...

Neurological and psychiatric disorders Anticonvulsants and anti-Parkinson’s medication must be co...

PATIENT ASSESSMENT History taking A thorough past medical history , surgical history and systemic...

PHYSICAL FITNESS Functional physical fitness can be judged by the ability to tolerate metabolic eq...

Respiratory disease Postoperative respiratory complications, such as pneumonia, are a major cause...

Risk prediction The key to managing patients e ff ectively is the identification and accurate quant...

Role of critical care and outreach services Reports from the National Confidential Enquiry into Pa...

Valvular heart disease While anaesthetic management is altered to achieve haemo dynamic stability...