Anaesthetists Handbook - MEDICAL EDUCATION at University ...
Anaesthetists Handbook - MEDICAL EDUCATION at University ...
Anaesthetists Handbook - MEDICAL EDUCATION at University ...
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Miscellaneous issuesletters and results of investig<strong>at</strong>ions which can be reviewed withinCRRS. In the event th<strong>at</strong> no list has been published, please confirmwith the nurse in charge of ward 50 th<strong>at</strong> no surgical procedures areplanned for th<strong>at</strong> the<strong>at</strong>re session.Attempts to arrange to admit p<strong>at</strong>ients the day before surgery areoften constrained by availability of beds. This often results in p<strong>at</strong>ientsbeing admitted the evening prior to surgery or the morning of surgery.To allow sufficient time for optimis<strong>at</strong>ion, and to check the relevantinvestig<strong>at</strong>ions, admissions from home will be reviewed by the renalteam in the days prior to surgery when p<strong>at</strong>ients <strong>at</strong>tend for dialysis orsurgical assessment. The renal team are appreci<strong>at</strong>ive of theanaesthetic support provided <strong>at</strong> UHCW and will upd<strong>at</strong>e you onclinical developments if you inform them of your role in the p<strong>at</strong>ients’p<strong>at</strong>hways. If required additional bloods could be analysed andappropri<strong>at</strong>e referrals made to minimise cancell<strong>at</strong>ions.A full set of medical notes should be available to the anaesthetist forreview. Notes should include previous anaesthetic and surgery, thest<strong>at</strong>us of renal function, (or degree of dysfunction), and currentmedic<strong>at</strong>ions th<strong>at</strong> the RRT p<strong>at</strong>ient is currently receiving.Comprehensive clinic letters and discharge summaries will beavailable on CRRS.Preoper<strong>at</strong>ive investig<strong>at</strong>ions should include FBC, coagul<strong>at</strong>ion screen,urea and electrolytes, liver function, ECG and chest X-ray (recentunless clinical changes have occurred since the CXR).P<strong>at</strong>ients should continue to receive their usual medic<strong>at</strong>ion the nightbefore anaesthesia, and antihypertensives, other cardiac andrespir<strong>at</strong>ory medic<strong>at</strong>ions on the morning of anaesthesia. If a preanaestheticmedic<strong>at</strong>ion is prescribed, it should be administered <strong>at</strong> thetime requested.FastingFor p<strong>at</strong>ients scheduled to receive general anaesthesia, regionalnerve plexus block or local anaesthesia with sed<strong>at</strong>ion the followingrecommend<strong>at</strong>ions must be observed.For morning list (am)Overnight fast232 <strong>Anaesthetists</strong> <strong>Handbook</strong> January 2010
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