Surgical complications / technical challenges
- Anti-coagulant use
- Previous intervention at surgical site
- Obesity
- Aberrant anatomy
Anaesthetic risk
- Cardio-respiratory co-morbidities – e.g. MI, LVF, COAD, HT
- Cerebrovascular disease e.g TIA, CVA
- Cardio-respiratory fitness e.g. exercise tolerance (very important), baseline oxygen saturation, ejection fraction, pulmonary function tests
- Aspiration risk e.g. fasting status, obesity, frequency of reflux symptoms, loose teeth
- Difficult intubation e.g. small mouth, short/stiff neck, ENT problems, previous anaesthetic problems
Likelihood of post-operative complications or need ICU/HDU?
- Ventilatory or Intropic support – cardiorespiratory illness (again), cardiothoracic surgery
- DVT/PE risk e.g. prolonged bed rest, obese
- Airway risk e.g. airway/ENT procedure
- Neurological deterioration e.g. neurosurgical or cerebrovascular surgery
Wound healing issues?
- Local factors e.g vascular disease, skin infection, obesity, poor nutrition
- Systemic factor e.g. diabetic, chronic steroids
Functional recovery and rehabilitation?
- Functional assessment / ADLS
- Social supports and assistance
- Alternative places for convalescence and recovery
Anaesthetic complications
- Cardiac – ischaemia, infarction, arrhythmia
- Circulatory – hypotension
- Respiratory – infection, aspiration, atectasis
- Airway damage / Dental damage
- Failure to oxygenate > Hypoxic brain damage
- Awareness