MMC Bramhall Campus Preop Assessments

Updated March 26, 2015    Author: VerLee

Description: Synopsis of PreOp testing guidelines, fasting guidelines, Anesthesia Consults, etc.

for MMC Scarborough Campus, including patient Exclusion Criteria, click here


Preop Labs

Pre-Op Spectrum Medical Group Lab Guidelines

Preop EKG

Pre-Op Spectrum Medical Group EKG Guidelines


Airway Assessment

malampati airway
Malampati Airway Classes: a somewhat helpful predictor of success of standard larygoscopy

Also provide cervical flexion and extension and dental assessment.


PreOp Fasting (NPO) Guidelines

ASA has updated the Preop Fasting Guidelines as of 2011. The entire article is available here.

Below is a Bulletized Summary:

ASA Fasting Guidelines 2011 (Adult & Pediatric)
Ingested Material Examples Minimum Elapsed Time Before Elective Procedure (general, regional, or MAC)
Clear Liquids water, fruit juices without pulp, carbonated beverages, clear tea, black coffee. No alcohol. Volume is less important than type of liquid 2 hours
Breast Milk Breast Milk 4 hours
Infant Formula Infant formula 6 hours
Solids & Non-Human Milk Light meal; toast and juice. Both type of food and amount must be considered. 6 hours
Fatty Meal, Fried foods, Meat Burger & Fries. Both type of food and amount must be considered. 8 hours

 

Pharmacologic Treament Recommendations by ASA

  • Gastrointestinal Stimulants (metoclopramide): No routine use
  • Blockade of Gastric Secretion ( H-2 Receptor Antagonists, Proton Pump Inhibitors): No routine use
  • Preoperative Antacids (Na citrate, Mg trisilicate): No routine use
  • Preoperative Antiemetics (droperidol, ondansetron): No routine use
  • Preoperative anticholinergics (atropine, glycopyrrolate): No routine use

Pediatric Premedication

The most common pediatric premedication regimen at Maine Medical Center is p.o.:

Midazolam (Versed) 0.3mg/kg to 0.5mg/kg, often combined with
Acetominophen syrup 10-15mg/kg

Onset 1-20'; may cause disorientation, respiratory depression. Occasionally there is paradoxical agitation.

Other premed drugs and routes are listed in the Pediatric Drug Dosage Pages (premeds) (Indrit Reso)


Anesthesia Consults

Anesthesia Consult Downloadable Form (click)

Hand-complete this form, PhotoCopy x2. One copy for Patient Record, One Copy for Consult Book in Anesthesia Office, One Copy for Spectrum Anesthesia Billing (see Consultation Guidelines). Also smart to let Floorwalker and Secretary know so that case is assigned appropriately.

Obstetrical Anesthesia Consult Downloadable Form (click)

Hand-complete form, PhotoCopy x2. One copy for Patient Record, One Copy for OB Notebook (Sutherland), One Copy for Spectrum Anesthesia Billing (put in box outside Paula's Office).


Cardiac Risk Stratification, Beta Blockade Protocol

Cardiac Risk Stratification & Beta Blockade Protocol

Cardiac Evaluation for non-Cardiac Surgery (Complete Guidelines from ACC/AHA 2014, pdf)


Endocarditis Prophylaxis

Infectious Endocarditis Prohylaxis Guidelines from Circulation 2007

 


The Pregnant Patient for PreTerm Surgery

go to the Obstetrics Pages