The document discusses preoperative investigations and teaching. For investigations, it describes conducting a full blood count, urea and electrolytes tests for patients over age 65, with certain medical conditions, or at risk of blood loss. Preoperative teaching aims to prepare patients for what to expect before, during, and after surgery through sensory, procedural, and process information. Sensory information covers sights, sounds, temperatures etc. in operating rooms. Procedural information explains preparations, restrictions, and the surgical and anesthesia process. Process information outlines what happens in admission, holding, operating and recovery areas. The goal is patient safety and understanding through addressing priority details.

1. Preoperative investigation and
preoperative teaching
-RIYA SANJAY BAGHELE
NAGPUR

2. Introduction :-
 1} Preoperative investigation :- The pre-operative assessment is an
opportunity to identify co-morbidities that may lead to patient
complicationsduring the anaesthetic, surgical, or post-operative
period. Patients scheduled for elective procedures will generally
attend a pre-operative assessment 2-4 weeks before the date of their
surgery.
 In this article, we shall look at the components of an effective pre-
operative history, examination and routine investigations that can be
performed.
 2} preoperative teaching :- In terms of the surgical patient, some of
the most important education we provide is preoperative education
before surgery. The goal of preoperative education is to not only
prepare the patient for surgery but also to prepare them for what to
expect following the surgery.

3. Pre-Operative Investigations :-
1) The nature of the exact investigations required depends on a number of
factors, including co-morbidities, age, and the nature of the procedure.
2) Each specific hospital is likely to provide local guidelines, however it is
useful to understand the tests than could be done pre-operatively and have
an appreciation as to why each may be requested. NICE produce a colour
traffic light table which can further guide your investigative decisions.

4. INVESTIGATIONS
1) FULL BLOOD COUNT (WHEN TO PERFORM )
•All emergency Pre-operative cases
•All elective Pre-operative cases over 6o years
•All elective Pre-operative cases in adult femalesIf surgery likely to
result in significant blood loss
Suspicion of blood loss,
anemia,sepsis, CRD,coagulation problems

5. 2.) UREA & ELECTROLYTES(WHEN TO
PERFORM?)
•All Pre-operative cases over 65Positive result from
U/A
•All pt with cardiopulmonary dis. or taking
diuretics, steroidsAll pt with H/O renal/liver dis.or
abn. nutritional state
All pt with H/O diarrhea/vomiting or other
metabolic/endocrine dis.
•All pt with IVF for more than 24hr's

15. PREOPERATIVE TEACHING :-
Pre operative teaching must address
highest priority and include information
that focus on safety of the patient. It
mainly concerns three types of
information. It include sensory,
procedural and process information

16. Sensory informations :-
•Holding area may be noisy
•Drugs and cleaning solution can be
smelled
•Operation theatre can be cold , warm
blankets are available
•Talking may be distorted in OT due to
mask. Questions should be asked if
something is not understood.

17. •OT bed will be narrow. A safety belt will be
applied over the knees
•Light in the OT may be very bright
•Monitoring machines (tickling and pinging
noises)may be heard when awake. Their
purpose is to monitor and ensure safety

18. Procedural information:-•What to bring and
what type of clothing wear to the
ambulatory surgery centre
• Any changes at the time of surgery
•Fluids and food restrictions
•Physical preparation required
•Purpose of frequent vital sign assessment

19. •Pain control and other comfort
measures
•Insertion of IV line
•Procedure for anaesthesia
administration
•Expected surgical site and or side
marked with ink or marker

20. Process information
•Admission area
•Preoperative holding area, operating room
amd recovery room
•Families can usually stay in holding area until
surgery
•Families may be able to enter recovery area
as soon as patient is awake

21. •Identification of any technology that
may present on awakeningsuch as
monitors and central lines

22. ----Thank you----