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Preop Assessment Pt 2: High Risk Patients

Last week, we reviewed the basics of preoperative assessment.

During the preoperative screening process, a patient may be identified to be a potentially high risk patient. The screening process involves the patient questionnaire, telephone triage & finally, the preadmission clinic.

Those identified as high risk would visit the preadmission clinic where a nurse or anaesthetist assesses them further. Members of the multidisciplinary team may be required to assess the patient prior to their procedure as well.

Remember that identifying high risk patients assists in preventing complications intraoperatively & in the immediate postoperative period. It also helps prevents complications occurring in the days, weeks & months following surgery. The multidisciplinary team is crucial during this period along with the patient’s GP however the patient themselves & the application of postop education will reduce the likelihood of complications more so.

So just who are likely high risk patients?

· The Elderly

· Those with multiple co-morbidities

- Particularly diabetics & those with vascular disease

· Those on multiple medications

· Those requiring general or major regional anaesthesia

· Those requiring a lengthy procedure (over 4hrs)

· Those who are nutritionally compromised

- Either underweight or obese

The tools that were discussed last week are also good predictors of high risk patients. By identifying these patients, the surgical & anaesthesia teams can prepare the operating theatre appropriately & for the patient to be educated on care pre & postoperatively.

Next week brings a new month & a new topic. We move onto the anaesthetic machine & monitoring. We will also do a 90 day check in for 2020.

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