Lesson 1Interpreting functional capacity and exercise tolerance in perioperative riskIt explains how to gauge functional capacity with METs, exercise endurance, and symptom-limited tasks, and how these insights shape perioperative heart and lung risks, testing choices, and the degree of post-surgery monitoring needed for optimal patient 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 preoperativelyIt centres on screening for obstructive sleep apnea, understanding the STOP-Bang score, perioperative hazards, and handling patients on CPAP, covering device checks, post-op monitoring, and ways to cut down on opioids for safer recovery.
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 deferIt makes 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 postpone or cancel surgery due to odd or absent results, ensuring efficient care.
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 testingIt handles checking diabetes type, management, and issues, setting sugar level goals around surgery, and arranging glucose checks, insulin and tablet changes, plus treating low and high sugar during operations for stable outcomes.
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 elevationIt tackles checking kidney function via creatinine, eGFR, and urine flow, stressing mild creatinine rise, its reasons, and effects on drug amounts, fluid handling, and exposure to dyes or kidney-harming substances in surgery.
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 principlesIt outlines thorough medication review, zeroing in on blood thinners, beta-blockers, ACE inhibitors, statins, and sugar tablets, with schedules for continuing or stopping, backup plans, and recording joint choices for smooth 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 stentIt delves into key heart risk tools, reading RCRI and ACS NSQIP, and using them for patients with blocked arteries and stents, directing surgery timing, checks, and heart specialist input for better results.
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 risksIt covers pinpointed history and body system checks to spot heart, lung, hormone, and airway dangers, highlighting warning signs, daily function, past anaesthesia troubles, and records that aid safe planning in busy wards.
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 airwayIt goes over bedside airway checks like Mallampati score, neck movement, mouth gap, and thyromental measure, blending them to forecast tough mask breathing, tube insertion, and readying alternative methods for emergencies.
Mallampati classification technique and limitsMouth opening, thyromental distance, and dentitionNeck mobility and cervical spine considerationsPredictors of difficult mask ventilationFormulating a difficult airway backup plan
