Pre-op Investigations

1. Pre-op Investigations

2. Purpose • Enhance and optimise quality of patient care • Minimise last minute cancellations • Promote efficient use of staff and resources • Increase theatre throughput • Establish a patient care pathway • At all times ensure patient safety

4. Not based on robust evidence • Varies a lot from place to place, patient to patient, doctor to doctor. • If considering PFTs, ECHO, ABGs, etc; if needed, d/w the anaesthetist doing the list, or someone you can reach (say I know you are not doing this list, but can you please advice me; & then thank them) • X-match – refer to your local guideline

5. http://www.aagbi.org/sites/default/files/preop2010.pdf • Routine pre-operative investigations are expensive, labour intensive and of questionable value, especially as they may contribute to morbidity or cause additional delays due to spurious results. • History and examination performed by appropriately trained and competent personnel remains the most efficient and accurate way of initially detecting significant morbidity. There is evidence that patients of any age with no major co-morbidities (ASA physical status 1 or 2) presenting for day surgery do not need pre-operative investigations.

6. Recommended reading • http://www.aagbi.org/sites/default/files/preop2010.pdf - Jan 2010 • http://www.nice.org.uk/guidance/index.jsp?action=download&o=29098 – Jan 2011 • http://www.nice.org.uk/nicemedia/pdf/cg3niceguideline.pdf - June 2003