medical notes

Apr 16th, 2015
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PREOPERATIVE & POSTOPERATIVE CAREIntroductionSurgeries vary from minor to major, day case or in-patient, elective or emergency.Surgical trends are changing from open to minimal accessNewer non-surgical interventions Learning objectives;At the end of this chapter you should be able to:Describe the preoperative evaluation processDescribe the preoperative preparation of patientsDescribe the post-operative proceduresDiscuss the common post-operative complications and their managementPREOPERATIVE CAREFactors for successful surgery;Good surgical skills and techniques.Proper patient evaluation (pathology).Patient selection (surgery indicated- safe live, relieve suffering and correct deformity).Patient follow-up.Patient administration & liaison (HCF, HMO).Preoperative evaluationComplete history and proper documentation: menstrual, reproductive, sexual, urologic, GIT, chronic conditions, drug history and allergies.Clinical examination- General (wt, ht, BP), CVS, Thyroid, RS, GIT, CNS, MS, Gynaecologic(Breasts, abdomen, pelvis& rectum).Elderly - complete neurologic examination with a dementia score.Physical & mental handicap should be noted & appropriate counseling taken.InvestigationFull Blood Count, Sickling test, urinalysis (dipstick) MCU- C/S for urologic proceduresPap smearSerum biochemistry (U/E/C, LFTs, Blood sugar)HIV, Hepatitis screenCoagulation profileChest X-ray, IVUPelvic ultrasound, MRIElectrocardiogramPreopera

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