Lesson 1Focused history taking: comorbidities, OSA screening (STOP-Bang), functional status, medication review, fasting statusThis lesson details structured preoperative history-taking, emphasising comorbidities, OSA screening using STOP-Bang questionnaire, functional capacity assessment, review of medications and allergies, and fasting guidelines to spot modifiable risks and plan anaesthesia.
Key comorbidities and prior anesthetic historySTOP-Bang and other OSA screening toolsAssessing functional capacity and exercise toleranceMedication, allergy, and anticoagulant reviewVerifying fasting status and aspiration riskLesson 2Diabetes management pre-op: glucose targets, perioperative insulin/oral hypoglycemics guidance, blood glucose testing timingCovers perioperative diabetes management, including preoperative glucose targets, adjustments for insulin and oral hypoglycaemics, prevention of hypoglycaemia, monitoring schedules, and coordination with surgical and endocrinology teams for complex diabetic patients.
Pre-op glucose targets and rationaleAdjusting basal and bolus insulin regimensManaging oral and non-insulin agentsBlood glucose testing timing and frequencyHypoglycemia recognition and preventionLesson 3Documentation checklist: crucial items to record for handover and anesthesia record continuityProvides a comprehensive checklist for essential preoperative documentation to ensure safe handover, including baseline assessments, risk discussions, consent verification, medication and allergy lists, ensuring continuity, traceability, and medico-legal safety.
Core elements of the anesthesia pre-op noteRecording comorbidities and risk scoresDocumenting medications, allergies, and NPO statusStandardized handover and transfer notesLegal and quality assurance considerationsLesson 4Respiratory and cardiovascular exam: auscultation, signs of heart failure, blood pressure control, peripheral perfusionFocuses on targeted respiratory and cardiovascular examination techniques, including inspection, auscultation, heart failure signs, blood pressure evaluation, volume status, and peripheral perfusion, linking findings to anaesthesia risks and patient optimisation.
Respiratory inspection and auscultationIdentifying wheeze, crackles, and obstructionCardiac auscultation and heart failure signsBlood pressure control and volume assessmentPeripheral perfusion and vascular statusLesson 5Identification of anesthesia-related risks: aspiration, difficult airway, hypoventilation, obstructive apnea, perioperative MI/stroke riskExplains identification of key anaesthesia risks like aspiration, difficult airway, hypoventilation, OSA episodes, and perioperative cardiac or stroke events, using clinical findings and risk tools to develop effective mitigation plans.
Assessing aspiration and full-stomach riskPredicting difficult mask and intubationOSA, hypoventilation, and opioid sensitivityEstimating perioperative MI and stroke riskPlanning risk mitigation strategiesLesson 6ASA physical status classification: criteria, examples, applying ASA class to this patient with obesity, HTN, diabetes, OSAReviews ASA physical status classification system, criteria for each grade, practical examples, and application to patients with obesity, hypertension, diabetes, and OSA, highlighting consistency, limitations, and role in risk communication.
ASA classes I–VI and E modifierClinical examples for each ASA classApplying ASA class to obesity and OSALimitations of ASA as a risk predictorUsing ASA in communication and recordsLesson 7Patient communication and informed consent: explaining plan, fasting, CPAP use, postoperative expectationsEmphasises effective patient counselling, shared decision-making, and informed consent process, covering explanation of anaesthesia plan, fasting instructions, CPAP usage, postoperative pain management, and documenting patient understanding.
Structuring the pre-op anesthesia discussionExplaining fasting, medications, and CPAP useDiscussing risks, benefits, and alternativesSetting postoperative expectations and recoveryAssessing understanding and documenting consentLesson 8Airway evaluation: Mallampati, thyromental distance, neck circumference, neck mobility, dentition, prior airway recordsDetails structured airway assessment using Mallampati score, thyromental distance, neck circumference, mobility, dentition check, and review of past airway records to formulate a difficult airway plan and enhance safety.
Mallampati and oropharyngeal assessmentThyromental distance and jaw protrusionNeck circumference and mobility evaluationDentition, prosthetics, and loose teethReviewing prior airway and anesthesia recordsLesson 9Selecting relevant preoperative investigations: labs, ECG, HbA1c, pregnancy test if indicated, CXR indicationsGuides appropriate selection of preoperative tests based on patient profile and surgery type, including blood tests, ECG, HbA1c, pregnancy test, and chest X-ray when needed, avoiding unnecessary investigations while ensuring compliance.
Principles of selective test orderingBaseline labs and renal function testsECG and cardiac testing indicationsHbA1c and diabetes optimization rolePregnancy tests and chest imaging criteria
