Pre-operative Surgical Clearances

AssociatesMD provides same day complete surgical clearances which include an appointment with our physician, lab work, electrocardiogram, and x-rays. We can facilitate appointments to get all you need done in one day at any of our locations (Davie, Weston, Plantation, and Kendall). Results will normally generate in 24-48 hours depending on the testing ordered. Results are then sent directly over to the referring physician or attorney.

Why Pre-operative Testing?
Pre-operative testing (e.g., chest radiography, electrocardiography, laboratory testing, and urinalysis) is often performed before surgical procedures. These investigations can be helpful to stratify risk, direct anesthetic choices, and guide post-operative management. The decision to order pre-operative tests should be guided by the patient’s clinical history, co morbidities, and physical examination findings. Patients with signs or symptoms of active cardiovascular disease should be evaluated with appropriate testing, regardless of their preoperative status. Electrocardiography is recommended for patients undergoing high-risk surgery and those undergoing intermediate-risk surgeries who have additional risk factors.

The goal of pre-operative evaluation is to identify and optimize conditions that increase pre-operative morbidity and mortality. Historically, testing before non-cardiac surgery involved a battery of standard tests applied to all patients (e.g., chest radiography, electrocardiography [ECG], laboratory testing, and urinalysis). More recent practice guidelines continue to recommend testing in patients guided by a pre-operative risk assessment based on pertinent clinical history and examination findings.

Pre-operative Patient Questionnaire History

  • The patient would be asked about his age. Some studies found a small increased risk of surgery with advanced age of the patient. The mortality rate for most surgical procedures increases linearly with age due to increasing numbers of co morbidities with advancing age.
  • The patient would be asked if he had a history of:
    • Heart diseases, irregular heartbeat, murmurs or rheumatic fever as a child.
    • Pulmonary diseases, such as asthma, bronchitis, or emphysema.
    • Chest pain, angina, or chest tightness.
    • Hypertension or hypotension.
    • Shortness of breath, cough.
    • Liver diseases, jaundice or hepatitis.
    • Gastrointestinal problems or indigestion.
    • Diabetes.
    • Thyroid problems.
    • Kidney problems.
    • Weakness or numbness in the extremities.
    • Seizures or blackouts.
    • Bleeding disorders.
    • Blood clotting abnormality.
    • Arthritis or joint pain.
  • The patient would be asked about:
    • Any allergies for food or medication.
    • A list of any medications he is currently taking, including over-the-counter medications and steroidal compounds.
    • Any other medical conditions in the past.
    • Any previous surgeries or anesthesia.
    • Pregnancy state.
    • Any problems with a previous surgery due to anesthesia.
  • The patient would be asked about his height and weight.
  • The patient would be asked about his exercise capacity.
  • The patient would be asked if he smokes cigarettes, how many packs per day and for how many years.
  • The patient would be asked if he drinks alcohol. There is increased risk for postoperative complications in patients who misuse alcohol on a regular basis.
  • The patient would be asked about his family history.

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