Anesthesia Focused H&P Presentation Age, gender, ASA status, weight, reason for surgery PMH/PSH/PAH, Meds, Allergies

s SHx/FHx NPO, dentition, functional statuspertinent + and - Vitals, Upper resp (Mallam, mouth, TM, extention flexion, madibular range, medial incisors), CV, Resp Labs, tests Risk, plan. H&P o PMH/PSH/PAH Adverse anesthesia rxns, difficult airway, PONV, prolonged paralysis o Allergies o Rx Tolerance EtOH, Benzos Bleeding ASA sympathetic response - -blockers, anti-HTN sympathetic response MAOIs, TCAs Antibiotics prolonged neuromuscular blocking drugs o FHx/SHx Hx of anesthesia death, malignant hyperthermia (AD, ryanodine receptor, volatile anesthetics/succinyl choline, dantrolene) o ROS NPO, Functional status, dentures CNS seizures, CVD CV CP, orthop, PND, arrhythmia, MI, CAD, exercise tolerance, claudication Resp SOB, OSA, cough, sputum, URI, PNA, PTX, asthma, COPD Hepatic EtOH, cirrhosis Renal CKD, dyalisis GI - GERD GU Pregnant M/S arthritis Heme bruising, anemia, DVT, bleeding Endo DM, thyroid, adrenal o PE Vitals: BMI, Wt, BP, HR, SaO2 o Labs Hgb, Plt, Cr

o ASA

o Risk o Anesthesia Plan

Functional Status 4 mets (4 blocks, 2 flights of stairs) Cardiac Risk Factors T Cholesterol >240mg/dL, HTN, Age >70, DM, Smoker Factors increasing risk of cardiac event o CHF, CAD, CVD, IDDM, Cr >2.0, high-risk surgery (all vessel disease) o Therefore B candidates (titrate to <65bpm) o 2-agonists (clonidine, dexmedetomidine, mivazerol) can be used if B are CI (e.g. asthma) Resp Risks Location: AAA and thoracic have highest Resp failure = no extubation >48hr Important to treat COPD and asthma aggressively before