Risk Type of procedure Examples Low Non-vital organs involved, exposed surgical site, limited dissection Lymph node biopsy, dental extraction, cataract extraction, most cutaneous surgery, laparoscopic procedures, coronary angiography Moderate Vital…
Etiology Description Consumption Seen in larger blood loss surgeries Occurs immediately after surgery Returns toward normal within 2–3 days Thrombocytopenia due to infection Associated with both viral and bacterial infections…
Drug Recommendation for practice Evidence levelb Glucocorticoids Continue; administer stress dose 5-ASA Discontinue on day of surgery and resume 3 days after surgery if normal renal function C Azathioprine, 6-MP…
© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_8 8. Perioperative Beta-Blockers Paul B. Cornia1 and Kay M. Johnson1 (1) Division of General Internal Medicine, Department of Medicine, University of…
Degree of thyroid dysfunction Laboratory findings Elective Urgent/emergent Treatment Subclinical ■ Increased TSH ■ Normal free T4 ■ Proceed ■ Proceed ■ None Mild–moderate ■ Increased TSH ■ Low free…
HPA axis status Glucocorticoid (GC) exposure Management NOT suppressed <3 weeks Every-other-day therapy AM dose of <5 mg prednisone or equivalenta Take usual AM dose of GC MAY be suppressed…
Rate control If NPO Individualize desired rate control target, depending on the patient’s baseline rate control goals, the presence of ischemic heart disease, and the patient’s post-op blood pressure. In…
Drugs to hold for at least 2 weeks preoperatively Aspirin: Hold for a minimum of 1 week; consider 2 weeks for neuro/spine surgery Warning: Must evaluate whether patient has received…
Requesting physician Usually the surgeon, sometimes a PCP or specialist, or anesthesiologist Consult for Specific reason for or question for consultation Chief complaint Include the intended surgical procedure Date of…
© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_5 5. Anesthesia Pearls Gail A. Van Norman1 (1) Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA…
