{"id":542,"date":"2016-08-12T03:03:14","date_gmt":"2016-08-12T03:03:14","guid":{"rendered":"http:\/\/emedsa.org.au\/CoreMed\/?p=542"},"modified":"2016-08-20T08:44:32","modified_gmt":"2016-08-20T08:44:32","slug":"peri-operative-assessment","status":"publish","type":"post","link":"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/12\/peri-operative-assessment\/","title":{"rendered":"Peri-operative Assessment"},"content":{"rendered":"<p><a href=\"http:\/\/twitter.com\/share?url=http%3A%2F%2Femedsa.org.au%2FCoreMed%2F2016%2F08%2F12%2Fperi-operative-assessment%2F&amp;count=none&amp;text=Peri-operative Assessment - CoreMed\" class=\"twitter-share-button\">Tweet<\/a><\/p><p><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-617 aligncenter\" src=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/PeriOperative.jpg\" alt=\"PeriOperative\" width=\"960\" height=\"639\" srcset=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/PeriOperative.jpg 960w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/PeriOperative-300x200.jpg 300w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/PeriOperative-768x511.jpg 768w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/PeriOperative-624x415.jpg 624w\" sizes=\"auto, (max-width: 960px) 100vw, 960px\" \/>Surgical complications \/ technical challenges<\/strong><\/p>\n<ul>\n<li>Anti-coagulant use<\/li>\n<li>Previous intervention at surgical site<\/li>\n<li>Obesity<\/li>\n<li>Aberrant anatomy<\/li>\n<\/ul>\n<p><strong>Anaesthetic risk<\/strong><\/p>\n<ul>\n<li>Cardio-respiratory co-morbidities &#8211; <em>e.g. MI, LVF, COAD, HT<\/em><\/li>\n<li>Cerebrovascular disease<em> e.g TIA, CVA<\/em><\/li>\n<li>Cardio-respiratory fitness <em>e.g. exercise tolerance (very important), baseline oxygen saturation, ejection fraction, pulmonary function tests<\/em><\/li>\n<li>Aspiration risk <em>e.g. fasting status, obesity, frequency of reflux symptoms, loose teeth<\/em><\/li>\n<li>Difficult intubation <em>e.g. small mouth, short\/stiff neck, ENT problems, previous anaesthetic problems<\/em><\/li>\n<\/ul>\n<p><strong>Likelihood of post-operative complications or need ICU\/HDU?<\/strong><\/p>\n<ul>\n<li>Ventilatory or Intropic support &#8211; cardiorespiratory illness (again), cardiothoracic surgery<\/li>\n<li>DVT\/PE risk <em>e.g. prolonged bed rest, obese<\/em><\/li>\n<li>Airway risk <em>e.g. airway\/ENT procedure<\/em><\/li>\n<li>Neurological deterioration <em>e.g. neurosurgical or cerebrovascular surgery<\/em><\/li>\n<\/ul>\n<p><strong>Wound healing issues?<\/strong><\/p>\n<ul>\n<li>Local factors <em>e.g vascular disease, skin infection, obesity, poor nutrition<\/em><\/li>\n<li>Systemic factor <em>e.g. diabetic, chronic steroids<\/em><\/li>\n<\/ul>\n<p><strong>Functional recovery and rehabilitation?<\/strong><\/p>\n<ul>\n<li>Functional assessment \/ ADLS<\/li>\n<li>Social supports and assistance<\/li>\n<li>Alternative places for convalescence and recovery<\/li>\n<\/ul>\n<p><b><a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/12\/peri-operative-assessment\/\">Anaesthetic\u00a0<\/a>complications<\/b><\/p>\n<ul>\n<li><strong>Cardiac<\/strong> \u2013 ischaemia, infarction, arrhythmia<\/li>\n<li><strong>Circulatory<\/strong> &#8211; hypotension<\/li>\n<li><strong>Respiratory<\/strong> \u2013 infection, aspiration, atectasis<\/li>\n<li><strong>Airway damage \/ Dental damage<\/strong><\/li>\n<li><strong>Failure to oxygenate &gt; Hypoxic brain damage\u00a0<\/strong><\/li>\n<li><strong>Awareness<\/strong><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>TweetSurgical complications \/ technical challenges Anti-coagulant use Previous intervention at surgical site Obesity Aberrant anatomy Anaesthetic risk Cardio-respiratory co-morbidities &#8211; e.g. MI, LVF, COAD, HT Cerebrovascular disease e.g TIA, CVA&#8230; <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/12\/peri-operative-assessment\/\">Read more &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":617,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"episode_type":"","audio_file":"","cover_image":"","cover_image_id":"","duration":"","filesize":"","date_recorded":"","explicit":"","block":"","filesize_raw":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-542","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/542","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/comments?post=542"}],"version-history":[{"count":5,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/542\/revisions"}],"predecessor-version":[{"id":743,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/542\/revisions\/743"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/media\/617"}],"wp:attachment":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/media?parent=542"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/categories?post=542"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/tags?post=542"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}