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Preoperative preparation.pptx

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Preoperative preparation.pptx

  1. 1. Tips on using my ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
  2. 2. Preoperative preparation
  3. 3. Preoperative preparation • outpatient office visit to hospital inpatient consultation to the emergency department evaluation of a patient. • depending on the nature of the complaint and proposed surgical intervention,
  4. 4. ROUTINE PREOPERATIVE PREPARATION FOR SURGERY
  5. 5. ROUTINE PREOPERATIVE PREPARATION FOR SURGERY • History • Physical examination • Special investigation • Optimization • Informed consent • Marking the site/side of operation • Antibiotic prophylaxis • Shaving • Bowel preparation
  6. 6. PREOPERATIVE EVALUATION •
  7. 7. PREOPERATIVE EVALUATION • Aim : not to screen broadly for undiagnosed disease but rather to identify and quantify comorbidity that may impact operative outcome.
  8. 8. • PAST Hx H/O DM, TB, HTN Bronchial Asthma, MI HIV Any previous operation.or bleeding tendency Any previous reaction to anaesthetic agent DRUGS Hx Interaction with anesthesia Drugs for HTN ,IHD to be cont.over preoperative period Anticoagulant drugs (aspirin, warfarin)
  9. 9. •Personal history Smoking Alcohol Occupation Diet Family History HTN, DM , TB, ALLERGIC DISORDER , CA , etc
  10. 10. PHYSICAL EXAMINATION
  11. 11. PHYSICAL EXAMINATION • PALLOR PULSE • ICTERUS B.P. • CYANOSIS BMI • JVP • CLUBBING • P.EDEMA
  12. 12. SYSTEMIC EXAMINATION
  13. 13. SYSTEMIC EXAMINATION Cardiovascular ■ Pulse, blood pressure, heart sounds, bruits, peripheral pulses, peripheral oedema Respiratory ■ Respiratory rate and effort, chest expansion and percussion note, breath sounds, oxygen saturation Gastrointestinal ■ Abdominal masses, ascites, bowel sounds, bruits, herniae, genitalia Neurological ■ Conscious level, any pre-existing cognitive impairment or confusion, deafness, neurological status of limbs
  14. 14. INVESTIGATIONS
  15. 15. INVESTIGATIONS • CBC Grouping, • S.Creatinine,S.Electrolyte • RBS/HbA1c • HbsAg • HIV • Urinalysis. • Xray Chest • ECG Echo TMT Angiography • LFT,Clotting screen • TSH
  16. 16. Optimization
  17. 17. Optimization Control • Hypertension • Diabetes mellitus • Thyroid function • Ascites , coagulation abnormalities • Renal function Hemodialysis • Angioplasty • Adrenal insufficiency • Respiratory exercises
  18. 18. Optimization Pheochromocytoma • controlled by a combination of a- adrenergic and ß-adrenergic blockade
  19. 19. Preop. Instructions
  20. 20. Preop. Instructions • NPO • Enema • Shaving -NO • Start DVT prophylaxis • Bath • Arrange blood for transfusion • Predeposit
  21. 21. Patient on Medications Continue- • Antithyroid, • Eltroxin, • Antihypertensives, • Digoxin, • Beta blocker • Antipsychotic
  22. 22. Patient on Medications Stop • Omit morning dose of antidiabetic • Warfarin
  23. 23. Patient on Medications Clopidogrel+ Aspirin ? • Stop if intracranial or post. chamber of eye operation
  24. 24. Informed consent
  25. 25. Antibiotic prophylaxis • Clean surgery –Single shot at the time of induction repeat if more than 3hours.
  26. 26. Marking the site/side of operation
  27. 27. PREOPERATIVE CHECKLIST
  28. 28. Get this ppt in mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
  29. 29. Get this ppt in mobile
  30. 30. Get my ppt collection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage

Editor's Notes

  • drpradeeppande@gmail.com
    7697305442

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