Preoperative Risk Evaluation课件.ppt

Preoperative Risk Evaluation: An Old School ApproachWith a Few New Tools;“Clear the Patient for Surgery”;What Causes Perioperative Mortality?;Are Internists Really Worth It?;Preoperative Risk Evaluationan Old School Approach;Global Assessment of Riskor“Looks good from door” ;ASA Patient Classification;Who is Too Sick or the “Are You Nuts?” Assessment;Predictors of Risk;Cardiac Perioperative RiskUpdated Old School Tools;Beyond the Goldman Cardiac Risk Index;Six Independent Predictors of Major Cardiac Complications;Revised Goldman Cardiac Risk Indexvs.Rate of Cardiac Death, MI, Cardiac Arrest;Revised Goldman Cardiac Risk Indexvs. Cardiac Death, MI, Cardiac Arrest, Vfib, Pulmonary Edema, Complete Heart Block;Revised Cardiac Risk IndexMost Studied and Validated;Functional Capacityor  “What’s the METs thing?”;Specific Activity Scale;How does this relate to Surgery?;What about Surgery Specific Risk?;Surgery Specific Risk for Cardiac Death or Nonfatal MI;The New School Uses:2007 ACC/AHA Cardiac Evaluation and Care Algorithm;Evaluating Cardiac Risk2007 ACC/AHA Algorithm;Evaluating Cardiac Risk 2007 ACC/AHA Algorithm;Evaluating Cardiac Risk2007 ACC/AHA Algorithm;Evaluating Cardiac Risk2007 ACC/AHA Algorithm;Evaluating Pulmonary RiskIt’s No Longer Just a Guess;Predictors of Pulmonary Complications;Predictors of Pulmonary Complications;Other Conditions That May Require Special Attention;Recommendations for Assessment of Pulmonary Risk;ASA Postoperative Pulmonary Complications;Arozullah Respiratory Failure Risk Index;Arozullah Respiratory Failure Index Scoring;Put It All Together;Strategies to Reduce Postoperative Pulmonary Complications;DVT Risk;DVT Risk;Endocarditis ProphylaxisOne from Column A and Column B;Endocarditis Prophylaxis;Medication ConsiderationsAspirin and Clopidogrel ;Medication Considerations andSpecific Medical Conditions