Anesthesia Student Survival Guide
Rebecca Minehart2010
It is important for anesthesiologists to approach each patient in a systematic way. Part of this preparation includes but not limited to: o Obtaining through medical history, reviewing previous anesthetic plans, checking for appropriate lab tests, ordering appropriate meds and blood products, performing a detail airway assessment, informing the patient and obtaining consent. History and Physical Obtain targeted H&P focusing on airway and organ systems affected by the anesthetic plan, type of surgery and choice of anesthetic agent. ➢ Common Organ systems Reviewed ▪ Cardiovascular-History of SOB, dyspnea, chest pain, edema, HTN, MI, Cardiac surgery, anticoagulant use, cardiac medications (i.e. diuretic, antihypertensives), CAD (was there a stress test or prior cardiac intervention, determining functional capacity (energy requirement with activity). Poor man's stress test-feeling after climbing 2 to 3 flights of stairs ▪ Pulmonary-is patient current smoker? as secretion management can be difficulty (smoking cessation for at least 8 wks.). Hx Asthma? (determine severity and triggers-stimulation during surgery can trigger bronchospasm, ▪ Hepatic/Renal-anesthetic agents are metabolized differently by liver or kidney, patient conditions might change our agent of choice. ▪ Gastrointestinal-history of acid reflux makes us worry about aspiration since patients are relaxed, is an indication for RSI (rapid sequence intubation)
