Lesson 1Focused history taking: comorbidities, OSA screening (STOP-Bang), functional status, medication review, fasting statusExplores systematic preoperative history with emphasis on comorbidities, OSA screening tools, functional capacity, medication and allergy review, and fasting status, to identify modifiable risks and guide anaesthetic planning and optimisation.
Key comorbidities and prior anaesthetic 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 timingDetails perioperative diabetes optimisation, including pre-op glucose targets, timing and adjustment of insulin and oral agents, hypoglycemia prevention, monitoring schedule, and coordination with surgical and endocrine teams for complex cases.
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 anaesthesia record continuityOutlines essential documentation for safe anaesthesia care, including baseline assessments, risk discussions, consent confirmation, medication and allergy lists, and handover notes that ensure continuity, traceability, and medico-legal protection.
Core elements of the anaesthesia pre-op noteRecording comorbidities and risk scoresDocumenting medications, allergies, and NPO statusStandardised handover and transfer notesLegal and quality assurance considerationsLesson 4Respiratory and cardiovascular exam: auscultation, signs of heart failure, blood pressure control, peripheral perfusionDescribes focused respiratory and cardiovascular examination, including inspection, auscultation, signs of heart failure, blood pressure assessment, volume status, and peripheral perfusion, linking findings to anaesthetic risk and 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 anaesthesia-related risks: aspiration, difficult airway, hypoventilation, obstructive apnoea, perioperative MI/stroke riskExplores identification of anaesthesia-related risks such as aspiration, difficult airway, hypoventilation, OSA events, and perioperative cardiac or neurologic events, integrating clinical findings and risk tools to guide mitigation strategies.
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, criteria for each class, common clinical examples, and application to patients with obesity, hypertension, diabetes, and OSA, emphasising consistency, limitations, and impact on 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 expectationsFocuses on effective patient communication, shared decision-making, and informed consent, including explanation of anaesthetic plan, fasting, CPAP use, postoperative pain control, and documentation of understanding and questions addressed.
Structuring the pre-op anaesthesia 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 recordsCovers structured airway assessment using Mallampati, thyromental distance, neck mobility, dentition, and prior records, integrating findings into a difficult airway plan and documentation to enhance perioperative safety.
Mallampati and oropharyngeal assessmentThyromental distance and jaw protrusionNeck circumference and mobility evaluationDentition, prosthetics, and loose teethReviewing prior airway and anaesthesia recordsLesson 9Selecting relevant preoperative investigations: labs, ECG, HbA1c, pregnancy test if indicated, CXR indicationsGuides selection of preoperative investigations based on patient risk and procedure, including labs, ECG, HbA1c, pregnancy testing, and chest imaging, avoiding unnecessary tests while ensuring safety and regulatory compliance.
Principles of selective test orderingBaseline labs and renal function testsECG and cardiac testing indicationsHbA1c and diabetes optimisation rolePregnancy tests and chest imaging criteria
