preanesthesiaassessmentppt课件.pptx

Preanesthesia assessment 术前评估 理想麻醉要求 什么是理想麻醉？ 理想麻醉要求 安全 无痛 精神安定 适当肌松 麻醉方式有哪些？ PAME PAME PAME：Preanesthetic Medical Evaluation Apply to all patients undergoing sedation or any type of anesthesia for a procedure. To assure patients are appropriately prepared for procedures completed under sedation or any type of anesthesia. PAME An anesthesia care plan is based upon: Reviewing the medical record. Interviewing and examining the patient to: Discuss the medical history, previous anesthetic experiences and drug therapy. Obtaining and/or reviewing tests and consultations necessary for appropriate anesthesia care. Determining the appropriate prescription of preoperative medications as necessary to the conduct of anesthesia. The anesthesia provider shall verify that the above has been properly performed and documented in the patient’s electronic medical record. When does PAME occur? PAME Patients who are healthy, on minimal medications, with minimal medical problems, can have this occur on the day of the planned procedure, immediately prior to the procedure by the anesthesia provider responsible for the patient. All other patients need preoperative evaluation before the day of the procedure. What does PAME include? PAME Height (cm), weight (kg), and vital signs Review of systems Annotated active problem list Review of medications and allergies Focused physical exam of airway, heart and lungs Family history Ordering of any needed tests Routine laboratory and radiographic tests such as chest x-ray, CBC, Type and Screen or Crossmatch are required only if specifically indicated. How long is PAME “good?” PAME It depends on requirements of different medical institutions Whenever possible, the Medical Examination should be scheduled at least 3-5 clinic days prior to surgery. This is to allow time for often necessary testing, consultation and follow-up visits. PAME These evaluations are valid until something changes in the patient’s situation: New medications or change in d