Preoperative medical evaluation of the healthy patient

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Synopsis

The preoperative evaluation of

healthy patients should include the following:
  • A screening questionnaire for all patients

  • A history of exercise tolerance for all patients

  • Blood pressure and pulse for all patients

  • History and physical examination if one of the above is abnormal, in patients over 60 years, or in those undergoing major surgery

  • Pregnancy test for women who may be pregnant

  • Hematocrit for surgery with expected major blood loss

  • Serum creatinine concentration if hypotension is expected, nephrotoxic drugs will be used, or the patient is above age 50

  • ECG recommendations as above, unless obtained within the previous month

  • Chest x-ray for patients over 60 years, or those with suspected cardiac or pulmonary disease, unless one has been performed within the past six months

  • Pulmonary function tests based upon the American College of Physicians position statement.

  • All other tests must be done only if the clinical evaluation suggests a likelihood of disease

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