Lesson 1Interpreting functional capacity and exercise tolerance in perioperative riskExplains how to check functional capacity using METs, exercise endurance, and symptom-limited tasks, and how these affect heart and lung risks during surgery, testing choices, and postoperative watch 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 preoperativelyFocuses on screening for obstructive sleep apnea, reading STOP-Bang scores, surgery-related risks, and handling patients on CPAP, including checking devices, postoperative monitoring, 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 preoperative tests like ECG, troponin, chest x-ray, heart ultrasound, and stress tests are needed, how to skip unneeded ones, and when to delay or stop surgery due to bad 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 blood sugar goals around surgery, and planning glucose checks, insulin and pill changes, and treating low and high sugar during 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 using creatinine, eGFR, and urine amount, stressing mild creatinine rise, its causes, and effects on drug amounts, 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 principlesGives details on systematic medication checking, focusing on blood thinners, beta-blockers, ACE inhibitors, statins, and sugar pills, with times to keep or stop, 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 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 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 body system checks to spot heart, breathing, hormone, and airway dangers, stressing warning signs, daily function, past anesthesia problems, and records that aid safe anesthesia 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, like 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
