Lesson 1Interpreting functional capacity and exercise tolerance in perioperative riskShows how to check functional capacity using METs, exercise endurance, and symptom-limited tasks, and how these affect heart and lung risks around surgery, test choices, and post-op monitoring levels.
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 preoperativelyLooks at screening for obstructive sleep apnoea, reading STOP-Bang scores, surgery risks, and handling patients on CPAP, including checking the device, post-op watch, and ways to cut opioid use.
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 pre-op tests like ECG, troponin, chest x-ray, heart ultrasound, and stress tests are needed, how to skip unneeded ones, and when to delay or cancel surgery due to 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 sugar targets around surgery, and planning glucose checks, insulin and tablet changes, plus treating low and high sugar near operations.
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 via creatinine, eGFR, and urine amount, stressing mild creatinine rise, its causes, and effects on drug doses, fluids, and exposure to dye or kidney-harmers.
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 step-by-step medicine review, key on blood thinners, beta-blockers, ACE inhibitors, statins, and sugar tablets, with timings to keep or stop, bridging plans, and records of joint 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 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.
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 body systems check to spot heart, lung, hormone, and airway dangers, highlighting warning signs, daily function, past anaesthesia troubles, and records for safe 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 like Mallampati score, neck movement, mouth opening, and thyromental distance, combining them to predict tough mask breathing, tube insertion, and backup plans.
Mallampati classification technique and limitsMouth opening, thyromental distance, and dentitionNeck mobility and cervical spine considerationsPredictors of difficult mask ventilationFormulating a difficult airway backup plan
