Summary

In study session I you have learnt

• The World Health Organization (WHO) defines health as a "state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity".
• There are a growing body of evidence demonstrates that a person's health depends on many external & internal factors.
• In the present time diseases are more predictably cured or at least controlled than at any time in the past.
• The anesthetist as health care team member has an opportunity to contribute in alleviating pain and sufferings and promote health if compromised with great dedication to patient safety.
• Pre anesthetic assessment include History, physical examination, investigations and consultation of respective department when necessary
• The pre-operative assessment is designed to present the patient for surgery in the best possible condition.
• The goals of preoperative evaluation include assessing the risk of coexisting diseases, modifying risks, addressing patient's concerns, and discussing options for anesthesia care.
• Any problems encountered during past anesthetics must be fully investigated. Records of previous anesthesia, medical and surgical problems, drug history and family anesthetic history are important.
• Physical examination mainly focuses on respiratory, cardiovascular problem and the existing specific problem.
• Classification of physical health status of patient is done after evaluating the patient which can predict a risk. In patients whose physical status is unreliable consultation with different specialties appropriate to the patient specific problem to clarify critical aspects of the patient's Pathophysiology is very important
• Any medical condition that can be corrected or improved must first be treated so that the patient is in the fittest possible physical state before surgery.
• Investigations depend on the extent of surgery, age and underline coexisting diseases.
• Depending on the patient condition, age and extent of surgery, Full Blood Count (CBC) or at least hemoglobin, Urinalysis, Chest x-ray where indicated, ECG in patients with a history of cardiac disease and BUN/creatinine and serum electrolytes may be considered routine.
• All competent patients have the right to give or withhold consent for treatment or examination. To obtain consent, the patient must be given sufficient details and information about the procedure to enable a proper decision to be taken.
• After the preoperative evaluation, the anesthesia plan can be completed and the fasting time notified. The plan should list drug choices and doses in detail, as well as anticipated problem.
• The term Premedication is used to describe the administration of drugs before operation, with the general aims of lessening anxiety and fear and contributing to the ease and safety of the anesthetic.
• Purposes of premedication include: to alleviate anxiety and fear, reduce the volume and acidity of gastric contents, reduce secretions, prevent undesirable reflexes, reduce post-operative nausea and vomiting and facilitate induction and reduce the dose of anesthetic required.
• Drugs used for premedication include: sedatives , narcotics , anticholinergics ,antacids and anti-emetics
• The anesthetic plan discussed and agreed with the patient should be documented, including a list of the risks which have been explained