1. Evaluation of the patient and preoperative preparation:
a. ASA physical status.
b. Risk assessment.
c. NPO recommendations
d. Physical examination
i. Normal vital signs
ii. Airway evaluation
iii. Pulmonary evaluation
iv. Cardiac evaluation
v. Neurologic evaluation
2. Pre-operative laboratory testing, limitations, and cost-effectiveness analysis.
3. Indications, evaluation, and limitations of pregnancy test.
4. Indications, evaluation, and limitations of pulmonary function test including chest X-ray.
5. Indications, evaluation, and limitations of cardiac screening studies (EKG, exercise and pharmacologic stress tests, echocardiography, coronary catheterization).
6. Specific disease states: Assessment and preoperative management:
a. Endocrine – Diabetes, thyroid dysfunction, parathyroid disorders, adrenal disorders.
b. Cardiac – hypertension, ischemic heart disease, valvular heart disease, heart failure, dysrhythmias/pacemakers.
c. Pulmonary – obstructive lung disorders, sleep apnea, lung cancers, infectious disease including URI’s.
d. Hepatic – hepatitis, cirrhosis, alcohol abuse.
e. Renal – insufficiency, failure.
f. Neurologic – substance abuse, stroke, seizure disorders, neuromuscular disorders.
g. Vascular – carotid stenosis, aneurysms.
h. Hematologic – anemias, coagulopathies (congenital, acquired, pharmacologic).
i.
Malignancy
j.
Morbid obesity
7. Indications and evidence-based rationales for prophylactic perioperative beta blocker therapy.
8. Proper selection of patients for ambulatory surgeries.
9. Considerations and advice for patients on dietary and herbal supplements.
10. Considerations and advice for patients who may require transfusions.
11. Considerations and advice for patients who are Jehovah’s Witnesses.
12. Considerations and advice for patients who have DNR/DNI order.
13. Considerations and advice for patients who have history of post-operative nausea and vomiting.
14. Considerations and advise for patients who have history of post-operative delirium.
15. Considerations and advise for patients who have history of difficult airway.
16. Considerations and advise for patients who have history of intra-operative recall.
17. Considerations and advise for patients who have history of chronic pain syndrome.
18. Considerations and advise for patients who have upper respiratory infections.
19. Considerations and advise for patients who have pacemakers or AICD’s.
20. Considerations and advise for patients who have personal or family history of anesthetic complications (malignant hyperthermia, allergic reaction, cardiopulmonary collapse … etc).
21. Indications and rationales for appropriate usage of consultants.
22. Indications and rationales for appropriate postponement or cancellation of surgery.
23. Providing and obtaining proper informed consent.
24. Indications and choices of premedications.