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Pre-Assessment - Coggle Diagram

- - - - ECG
    - - ECHO
  - - - Not routin
        Only when indicated
    - - Chronic lung condications for baselines
        Undiagnosed / unclear respiratory disease
  - - - Determines blood groups and antibodies
        Have blood already tested for a potential future need
      - 40min
    - - Test pt bloods against an already prepared unit to see if reaction ocurs
      - 40min
      - g/s and xm together is 80min
- - - - Baseline blood pressure
        
        Target organ damage ( renal fx, ECG)
      - Continue antihtn up until surgery
        
        STOP ACe / ARBS DOS
        
        Dont's stop BB - repound hypertension
        
        Actively mx if SBP > 180 or DBP > 110 periop
    - - HFrEF
        
        Prone to volume overload
      - HFpEF
        
        Preload dependent - stiff ventriicles - maybe more fluids
      - What to do
        
        Establish EF
        
        (+) Echo + NTproBNP
      - Staging
        
        AHA
        NYHA
    - - First on the list
        
        Keep on oral meds
        
        Insulin sliding scale if insulin dependednt
      - Caution
        SGLT2 3D before
        GLP-1 : Safe to condtinue but risk of aspiration - notify
      - Check HGT preop +/- serum ketone
    - - Causes
      - Workup
        
        FBC
        iron studies
        G/H
        Units on standby
        IF an anticoa or risk of bleeding diathesis - clotting profile
      - Transfuse preop if:
        
        MAjor surgery
        Hb <8 generally
      - Iron therapy for iron deficiency
        
        Oral replacement 3-4 months
        Iv replacement min 10 days prior to surgery
    - - HASBLED score
        CHADS2VASC score
      - Warfain: Stop 5D before and bridge with clexane : stop clexane 12hrs before surgery
      - Asipirin: Continue
      - Antiplatelets
        
        Discuss before stopping!
    - - Cautery can interfere with device
      - Technique: Bipolar device
      - Recent interegation
      - If cautery is near deive - turn off device and prepare to defib during surgery
    - - GA are safe
        Don't have codeine
        First on the list
        Minimise time in hospital