Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode, which is the

second in the surgery series, I'm going to be talking about pre-operative care. And you can find

written notes on this topic at zero-definals.com slash pre-dash-op or in the general

surgery section of the 0-2-finals surgery book. So let's get straight into it. Before going to

theater for an operation, there are a number of things that need to be checked off. And these include

the pre-operative assessment

or pre-op, consent for the operation, blood tests including a group and save or cross-match

in case a transfusion is needed. The patient needs to be fasted. There may need to be some

medication changes and they need a venous thromboembolism risk assessment.

Let's start by talking about the pre-operative assessment.

Patients need to be assessed to determine whether they're fit to undergo the specific operation that's being proposed.

This involves exploring their comorbidities or their other health conditions,

their risk of having an anesthetic, their frailty status and their cardiorespiratory baseline fitness.

Therefore, they need a full history of their past medical problems, previous surgery, previous

adverse responses to anaesthetics, medications that they're on, any allergies that they have,

their smoking status and how much alcohol they drink.

Pregnancy needs to be considered in women of childbearing age.

Consider asking about a family history of sickle cell disease before any operation

and perform a general examination to look for cardiovascular and respiratory disease.

Patients who may be malnourished, for example, if their BMI is under 18.5,

or they've had significant unintentional weight loss, may need input from a dietitian and

additional nutritional support before surgery and during the admission. Let's talk about the ASA grade. And this refers to the American

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