|
|
Points |
Patient body habit |
|
4 |
|
Height |
2 |
|
Weight |
2 |
Airway evaluation |
|
10 |
|
current status |
5 |
|
H/o Airway management |
5 |
Vent settings |
|
10 |
|
mode |
2 |
|
PEEP |
2 |
|
FiO2 |
2 |
|
other settings |
2 |
|
Vent switch - allowed? |
2 |
Current vitals |
|
6 |
|
SpO2 |
2 |
|
BP |
2 |
|
HR |
2 |
Special Monitoring |
|
5 |
Lines/Access |
|
5 |
Anesthesia history |
|
2 |
|
history |
1 |
|
record if history present |
1 |
Eneteral feeds - cont/on hold/NPO |
|
1 |
Allergies (inc. Latex allergy) |
|
5 |
Labs |
|
6 |
|
HB |
2 |
|
K |
2 |
|
Cr |
2 |
Blood availability |
|
10 |
|
Preop T&S |
5 |
|
Preop T&C |
4 |
|
Blood antibodies? |
1 |
PMH |
|
5 |
Past Surgical History |
|
2 |
Medications |
|
10 |
|
Anti-coagulations |
2 |
|
Infusions (Pressors and Others) |
2 |
|
Antibiotic regimen (last dose, next dose) |
2 |
|
Antibiotic regiment - last dose |
2 |
|
Antibiotic regimen - next dose |
2 |
Last dialysis if applicable |
|
5 |
Studies - ECHO etc |
|
5 |
Information of the scheduled procedure |
1 |
Anesthesia consent |
|
5 |
Anesthesia Plan |
|
4 |
Total |
|
100 |