 
Class of 2017
 Go Back | | Session Title: | | SURG: Pre-operative Assessment | | | | Description: | | | | Keywords: |
| Blueprint ID | Learning Objectives | | 1218 | Obtain a focused history and physical that address pre- operative care. | | 1219 | Describe features of a patient’s clinical history that influence surgical decision-making. (a) Consider known diseases, risk factors, urgency of operation, medications, etc. | | 1220 | Discuss tools that may assist in pre-operative risk assessment. Consider laboratory studies, imaging studies, etc. Include the following: (a) pulmonary (examples: exercise tolerance, pulmonary function testing) (b) cardiovascular (ASA classification, Goldman criteria, echocardiography, thallium studies, Doppler) (c) renal (BUN/Cr, dialysis history) (d) metabolic (nutritional assessment, thyroid function) | | 1221 | Compare and contrast anesthetic risk factors. Consider the following variables: (a) age: neonates to geriatrics (b) urgency of intervention (c) emergent vs. elective surgery (d) associated conditions: pregnancy, diabetes, COPD, valvular or ischemic heart disease, cerebral/peripheral vascular disease, renal insufficiency, etc. | | 1222 | Discuss history, physical and laboratory findings utilized in nutritional assessment, and identity the most common forms of nutritional and deficiency disorders. Consider protein-calorie malnutrition, chronic alcoholism, iron and B12 deficiencies, malabsorption syndromes, and requirements of the morbidly obese. (a) Discuss disease states and surgical interventions at high risk for nutritional impairment. (b) Outline the advantages and disadvantages of nutritional support. (c) Compare and contrast enteral vs. parenteral administration. (d) Identify complications. (e) Outline methods of determining requirements and assessing response. | | 1223 | Outline the components of informed consent as they apply to surgical interventions (procedures, transfusions, etc). (a) Demonstrate documentation of consent in the medical record. (b) Discuss the rationale for documentation in the medical record. (c) Describe the components and demonstrate the ability to compose an operative or procedure note. | | 1224 | Describe the indications and efficacy of various monitoring techniques. (a) Compare and contrast invasive vs. non-invasive. (b) Consider vital signs, input and output, arterial lines, pulse oxymetry, ABG, ECG, Swan Ganz, CVP, ICP, etc.
| | 1225 | Identify conditions that potentially interfere with fluid and electrolyte homeostasis in the peri-operative period, and outline strategies for replacement/monitoring. Examples: effects of bowel preparation, NPO status, NG drainage, dialysis, operative losses, etc. | | 1226 | Identify factors that might impair coagulation or increase risk of bleeding. (a) Describe the various blood component therapies available. (b) Explain the indications, risks, and benefits of transfusion therapy. (c) Consider packed cells vs. whole blood, FFP, platelets, cryoprecipitate, albumin. (d) Discuss alternatives to allogeneic blood transfusion and their appropriate use. Include autologous donation, hemodilution, iron/erythropoetin therapy, and modification of transfusion trigger. | | 1227 | Discuss risk factors for alcohol withdrawal syndromes. Consider prevention strategies. | | |
| Blueprint ID | Course Goals | | 10387 | EPA 1 (AAMC): Gather a history and perform a physical examination
Linked Program Competencies
To This Course Goal: me-1 me-2 me-6 cm-1 cm-2 ha-1 pr-1 | | 10388 | EPA 2 (AAMC): Prioritize a differential diagnosis following a clinical encounter
Linked Program Competencies
To This Course Goal: me-4 me-6 cm-1 cm-2 cm-6 co-2 ha-1 ha-2 sc-1 sc-2 sc-3 pr-1 | | 10390 | EPA 4 (AAMC): Enter and discuss orders and prescriptions
Linked Program Competencies
To This Course Goal: me-5 me-6 cm-3 cm-4 cm-5 cm-6 co-2 co-3 ld-2 ld-3 ha-3 sc-2 pr-1 | | 10391 | EPA 5 (AAMC): Document a clinical encounter in the patient record
Linked Program Competencies
To This Course Goal: me-1 me-2 me-3 me-4 me-5 me-6 cm-5 cm-6 co-1 co-3 ld-3 pr-1 | | 10393 | EPA 7 (AAMC): Form clinical questions and retrieve evidence to advance patient care
Linked Program Competencies
To This Course Goal: me-6 cm-3 cm-5 cm-6 ld-2 ld-3 sc-1 sc-2 sc-3 pr-1 | | 10396 | EPA 10 (AAMC): Recognize a patient requiring urgent or emergent care and initiate evaluation
Linked Program Competencies
To This Course Goal: me-1 me-2 me-3 me-4 me-5 me-6 cm-1 cm-2 cm-3 cm-4 cm-5 cm-6 co-1 co-2 co-3 ld-1 ld-2 ld-3 ha-3 sc-1 sc-2 pr-1 | | 10397 | EPA 11 (AAMC): Obtain informed consent for tests and/or procedures
Linked Program Competencies
To This Course Goal: me-3 me-5 me-6 cm-1 cm-3 cm-4 cm-5 ld-2 ld-3 ha-1 ha-3 sc-2 sc-3 pr-1 | | 10398 | EPA 12 (AAMC): Perform general procedures of a physician
Linked Program Competencies
To This Course Goal: me-3 me-5 me-6 cm-1 cm-3 cm-4 cm-5 cm-6 co-1 co-3 ld-2 sc-1 sc-2 pr-1 | | me-1 | Medical Expert
Perform a complete and accurate patient-centred history appropriate to the patient’s presentation. | | me-2 | Medical Expert
Perform a complete and accurate physical examination appropriate to the patient’s presentation. | | me-6 | Medical Expert
Apply knowledge of the clinical, socio-behavioural, and fundamental biomedical sciences relevant to a clinical problem. | | cm-1 | Communicator
Develop and maintain appropriate ethical and therapeutic relationships, rapport and trust with patients and their families. | | cm-2 | Communicator
Collect and synthesize accurate and relevant information, incorporating perspectives from patients and their families, colleagues and other health care professionals. | | ha-1 | Health Advocate
Identify the important determinants of health, risk factors for illness, interaction between the population and their physical, biological and social environment, and personal attributes. | | pr-1 | Professional
Demonstrate accountability to patients by applying best practices and adhering to high ethical standards. | | me-4 | Medical Expert
Develop a differential diagnosis and key clinical problem list following assessment of a patient. | | cm-6 | Communicator
Discuss effective strategies for communicating with third parties other than health care professionals. | | co-2 | Collaborator
Demonstrate effective consultation with other health care professionals to provide care for individuals, communities, and populations. | | ha-2 | Health Advocate
Identify public policies and trends that affect health locally, nationally, and globally, and barriers to access for populations, including persons with disabilities, the underserved and the marginalized. | | sc-1 | Scholar
Develop a plan for personal continued education. | | sc-2 | Scholar
Apply the principles of research, critical appraisal and evidence-based medicine to learning and practice. | | sc-3 | Scholar
Demonstrate facilitation of learning for health care professionals, patients and society as part of the professional responsibility. | | me-5 | Medical Expert
Develop a management plan for key clinical problems following assessment of a patient. | | cm-3 | Communicator
Discuss relevant health care information and management plans with patients and their families. | | cm-4 | Communicator
Develop a shared plan of care with patients, their families, and other health care professionals. | | cm-5 | Communicator
Demonstrate effective oral and written communication of information associated with a medical encounter. | | co-3 | Collaborator
Demonstrate respect for health care team members without bias (e.g., bias related to gender, ethnicity, cultural background or health care role). | | ld-2 | Leader
Apply evidence and management processes to effectively allocate health care resources. | | ld-3 | Leader
Describe the roles and responsibilities of physicians and governing bodies in the development and support of the health care system. | | ha-3 | Health Advocate
Assess and respond to issues in the Canadian health care system and advocate for patients at all levels. | | me-3 | Medical Expert
Formulate an initial plan of appropriate diagnostic and therapeutic procedures relevant to the patient’s presentation. | | co-1 | Collaborator
Demonstrate effective collaboration skills within the health care system. | | ld-1 | Leader
Identify strategies to effectively manage practice and career. |
| (013) CARDIAC ARREST | | (015-1) BLEEDING, BRUISING | | (058-2) DELIRIUM | | (107-1) FEVER AND HYPERTHERMIA | | (079-2) HYPOKALEMIA | | (099-2) HYPONATREMIA | | (009-2) HYPOTENSION, SHOCK | | (074-3) PRE-OPERATIVE MEDICAL EVALUATION | | (103) SUBSTANCE-RELATED OR ADDICTIVE | | (109) TRAUMA |
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