Clinical  Anaesthesia

Anaesthetic assessment and preparation for surgery

 

Not all patients need to be seen in a preoperative assessment clinic by an anaesthetist. This stage aims to ‘filter’ patients appropriately.

Screening to determine who needs to be seen is achieved by using either a questionnaire or interview, the content of which has been determined with the agreement of the anaesthetic department.

 

The process can be carried out in a number of ways: completion of a questionnaire by the patient, nursing or other staff who have received training, or occasionally by the patient’s GP.

 

The patients screened who do not need to attend the preoperative assessment clinic to see an anaesthetist:

  • have no coexisting medical problems;
  • require no or only baseline investigations, the results of which are within normal limits 
  • have no potential for, or history of, anaesthetic difficulties;
  • require peripheral surgery for which complications are minimal.

 

These patients should be seen at the time of admission by the anaesthetist, who will:

  • confirm the findings of the screening;
  • check the results of any baseline investigations;
  • explain the type of anaesthetic appropriate for the procedure;
  • have the ultimate responsibility for deciding it is safe to proceed.

Whoever is responsible for the anaesthetic assessment must take a full history, examine each patient and ensure that appropriate investigations are carried out.

When performed by non-anaesthetic staff, a protocol is often used to ensure all the relevant areas are covered. This section concentrates on features of particular relevance to the anaesthetist.