Lesson 1Interpreting functional capacity and exercise tolerance in perioperative riskDescribes how to assess functional capacity using METs, exercise endurance, and symptom-limited tasks, and how these affect perioperative heart and lung risks, test choices, and postoperative watch levels for better care.
Metabolic equivalents and activity examplesAssessing exercise tolerance by patient interviewLinking poor capacity to cardiac riskWhen low METs prompt further cardiac testingImpact on postoperative monitoring levelLesson 2Assessment and management of obstructive sleep apnea and CPAP use preoperativelyCenters on screening for obstructive sleep apnea, reading STOP-Bang scores, perioperative dangers, and handling patients on CPAP, including device checks, postoperative monitoring, and strategies to reduce opioid use safely.
STOP-Bang and other OSA screening toolsPerioperative risks of untreated OSACoordinating patient-owned CPAP devicesPostoperative monitoring and positioningOpioid-sparing and sedation precautionsLesson 3Laboratory and additional testing decisions: when to request ECG, troponin, chest x-ray, echo, stress testing, and when to deferMakes clear when preoperative tests like ECG, troponin, chest x-ray, echocardiography, and stress testing are needed, how to skip unneeded ones, and when to delay or stop surgery due to odd or missing results for patient safety.
Evidence-based indications for preop ECGRole of troponin and cardiac biomarkersWhen chest x-ray or pulmonary tests are neededIndications for echo and stress testingChoosing to defer or cancel for safetyLesson 4Evaluation of diabetes, glycemic targets, and perioperative glucose testingHandles evaluation of diabetes type, control, and issues, setting perioperative sugar targets, and planning glucose checks, insulin and pill adjustments, and treatment of low and high sugar around surgery in local contexts.
Assessing diabetes type, duration, and controlPerioperative blood glucose targets and rangesAdjusting basal and bolus insulin regimensManaging oral hypoglycemics on surgery dayProtocols for hypo- and hyperglycemia treatmentLesson 5Renal function assessment and implications of mild creatinine elevationDeals with checking kidney function using creatinine, eGFR, and urine output, stressing mild creatinine rise, its causes, and effects on drug doses, fluid handling, and exposure to contrast or kidney-harming agents.
Interpreting creatinine and estimated GFRRecognizing early chronic kidney diseaseDrug dosing adjustments in renal impairmentFluid strategy in patients with renal riskAvoiding perioperative nephrotoxic exposuresLesson 6Medication reconciliation: antiplatelets, beta-blockers, ACE inhibitors, statins, oral hypoglycemics and perioperative management principlesOutlines careful medication review, focusing on antiplatelets, beta-blockers, ACE inhibitors, statins, and oral sugar-lowers, with times to continue or stop, bridging methods, and records of joint decisions for safe care.
Verifying medication lists and adherencePerioperative management of antiplatelet agentsBeta-blockers, ACE inhibitors, and ARBs strategyStatins and other cardioprotective medicationsOral hypoglycemics and insulin adjustmentLesson 7Cardiac risk assessment: Revised Cardiac Risk Index, ACS NSQIP predictors, and application to CAD with stentLooks into main heart risk tools, reading RCRI and ACS NSQIP, and using them for patients with heart artery disease and stents, guiding surgery timing, monitoring, and heart specialist consults in practice.
Revised Cardiac Risk Index componentsUsing ACS NSQIP surgical risk calculatorsRisk categories and perioperative event predictionManagement of bare-metal and drug-eluting stentsIndications for cardiology consult or stress testingLesson 8Focused history and systems review for cardiovascular, respiratory, endocrine, and airway risksCovers aimed history and body systems check to spot heart, lung, hormone, and airway risks, highlighting warning signs, daily function, past anaesthesia problems, and records that aid safe anaesthetic planning.
Key cardiovascular history and red flag symptomsRespiratory history, smoking, and dyspnea assessmentEndocrine history with focus on diabetes and thyroidPrior anesthesia complications and family historyStructured airway history and symptom screeningLesson 9Airway assessment tools (Mallampati, neck mobility, mouth opening) and predicting a difficult airwayReviews simple bedside airway checks, including Mallampati class, mouth opening, thyromental distance, and neck movement, and combines findings to predict hard mask breathing, tube insertion, and plans for backup methods.
Mallampati classification technique and limitsMouth opening, thyromental distance, and dentitionNeck mobility and cervical spine considerationsPredictors of difficult mask ventilationFormulating a difficult airway backup plan
