Synopsis

The preoperative evaluation of

• 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