Patient Assessment - Anaesthesia Unravelled #2

Hello there! In this Anaesthesia Unravelled lesson we will be talking about the "Patient Assessment" for anaesthesia. This approach follows 5 steps:

Patient History

It is essential that we know the species, breed, age and sex of our patient. All of these aspects are important to determine the best anaesthetic protocol. Still, we must not forget the weight, which will have a direct influence on both the dose and the calculation of drugs.

Anamnesis

It is at this moment that we will understand how the patient lives. It is essential to gather as much information as we can from the owners! I usually prefer to follow a logical sequence, firstly addressing the central nervous system, then the cardiovascular, pulmonary, digestive and biotransformation ones. Finally, we ask if the animal was fasted. We mustn’t forget to always choose questions that are straightforward and easy to answer!

Physical Examination

The physical evaluation of the patient is essential to elucidate any suspicions we attained during the anamnesis and also to make a record of the “baseline” physiological parameters, which can be used for comparison during the anesthetic procedure. Start from a general approach, then cardiovascular, pulmonary and digestive.

Complementary exams

They are important to determine our anaesthetic protocol, but they shouldn’t be the priority of our approach, as should the anamnesis and physical examination. Customary pre-anaesthetic exams are ECG, total blood count and kidney and liver functions. However, we can require additional exams, such as blood gas analysis and imaging tests.

Risk of Anesthesia

With all this information at hand, we must define the patient's risk of anaesthesia, according to the ASA classification, which ranges from 1 to 5, according to the patient's physiological severity.


Watch this video to check out more!


Further reading
Complementary exams sheet - FZEA USP
Alef M, von Praun F, Oechtering G. Is routine pre-anaesthetic haematological and biochemical screening justified in dogs? Veterinary Anaesthesia and Analgesia, 35: 132-140, 2008.
González FHD, Campos R. (editores). Anais do I Simpósio de Patologia Clínica Veterinária da Região Sul do Brasil. 2003, 98p.
Freitas GC, Carregaro AB. Avaliação Pré-anestésica e Morbidade Anestésica. In: Luna SPL, Carregaro AB. Anestesia e Analgesia em Equídeos, Ruminantes e Suínos. Ed MedVet. 1a ed. 2019, 225-245.
Futema F. Avaliação pré-anestésica. In: Fantoni DT, Cortopassi SRG. Anestesia em Cães e Gatos. 2a ed. Editora Rocca, 2010. p. 73-82.

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