MULTIDISCIPLINARY APPROACH TO PREOPERATIVE PATIENTS ASSESSMENT FOR SURGERY
Keywords:
anaesthesia, surgery, evaluation and preparation of the patient, co-existing diseases, consultationsAbstract
Background. A good cooperation of the anaesthesiologist with doctors of other specialities is needed in preoperative assessment of the patient to increase efficiency, lower the costs and improve quality of patients’ assessment for surgery in anaesthesia.
Methods. Fundamental processes for the anaesthesiologist when preparing the patient before surgery are taking a detailed history and performing a systematic clinical examination. They are followed by specific examinations according to the results of physical examination, age of the patient, coexisting diseases, bad habits and extent of the surgery. The anaesthesiologist can then take a decision about the most suitable type of anaesthesia for the patient in accordance with the accepted guidelines. A family practitioner can play a crucial role in the preoperative assessment as he/she knows the patient best. Foremost, he/she can also decide which examinations should the patient undergo before admission to the hospital for the elective surgery. At the hospital, consultants of different specialities are asked to cooperate with the anaesthesiologist according to the nature of the patient disease. The ward doctors are informed about the patient’s special needs after the surgery. The anaesthesiologists play a crucial role in taking care of badly injured and critically ill patients. As the head of the trauma team, the anaesthesiologist has to cooperate with the doctors of different specialities, such as general practitioners, who are in charge of the prehospital care, then with surgeonstraumatologists and other specialists according to the pathology of the patient.
Results. Cooperation of doctors of different specialities is valuable in the preoperative assessment of the patient, though it is sometimes time consuming. The lost time can be fatal for the patient.
Conclusions. A more personal approach in communication with consultants is needed. Merely writing notes is just not enough. A consultant would so get a clearer picture of the patient and the anaesthesiologist a quicker and exhaustive answer to the questions. A proper and efficient communication is needed between the prehospital doctor and the anaesthesiologist. Hospitals should provide better technical conditions for adequate communication.
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