Lesson 1Interpreting functional capacity and exercise tolerance in perioperative riskExplains how to check functional capacity using METs, exercise endurance, and symptom-limited activities, and how these affect perioperative heart and lung risks, testing choices, and level of postoperative watching.
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 preoperativelyFocuses on screening for obstructive sleep apnea, reading the STOP-Bang score, perioperative dangers, and handling patients using CPAP, including checking devices, postoperative watching, and strategies to cut down on opioids.
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 unnecessary ones, and when to delay or cancel surgery based on odd or missing results.
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 testingCovers checking diabetes type, control, and issues, setting perioperative blood sugar targets, and planning glucose checks, insulin and oral medicine changes, and treating low and high blood sugar around surgery.
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 amounts, fluid handling, and exposure to contrast or kidney-harming substances.
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 principlesGives details on systematic medicine checking, focusing on antiplatelets, beta-blockers, ACE inhibitors, statins, and oral hypoglycemics, with times for continuing or stopping, bridging methods, and recording shared choices.
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 major heart risk scores, reading RCRI and ACS NSQIP, and using them for patients with coronary artery disease and stents, guiding surgery timing, watching, and perioperative heart specialist talks.
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 targeted history and system reviews to spot cardiovascular, respiratory, endocrine, and airway risks, stressing warning signs, functional state, past anaesthesia problems, and records that back 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 bedside airway check tools, including Mallampati class, mouth opening, thyromental distance, and neck movement, and combines findings to predict tough mask breathing, intubation, 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
