Pre-op labs

[MikeMerk-MtS]

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Assuming no acute changes in symptoms, how long do you consider an EKG or labs (CBC, chem, etc) good for prior to surgery? 1 month? 6 months? 1 year?

 

[chocomorsel]

Depends on the surgery and comorbidities.
Plenty of surgeries need nothing.

 

[kmurp]

Our protocol:

The following is intended as a guide and may be individualized by the attending surgeon and anesthesiologist.
The Department of Anesthesia accepts results of laboratory tests performed within three months prior to the date of surgery.
Tests done prior to three months before the date of surgery may be acceptable at the discretion of the surgeon and anesthesiologist.
ECG interpretations are acceptable up to one year prior to the date of surgery if no changes have been noted in the patient’s cardiac status.
Pregnancy Testing: Females after onset of menses, who have not undergone a sterilization procedure, will be required to complete a urine pregnancy test on the day of surgery. A consent (Attachment C) for pregnancy testing will be signed by the patient (or guardian). Refusal of pregnancy test will lead to case cancellation.

Pre-anesthesia testing is not required for any patient scheduled for low risk procedures scheduled under Monitored Anesthesia Care.

Preoperative testing, (other than pregnancy testing as described above), is not required for any healthy ASA 1 patient.


For patients who are having more than a minor procedure under MAC Anesthesia:


EKG: Age >50, history of heart disease, HTN, OSA, Diabetes, pulmonary Disease, BMI >40

CBC: History of anemia, recent chemotherapy, liver or kidney disease, bleeding disorder, pulmonary disease, BMI>40

PT/PTT: Coumadin therapy, liver disease, consider INR on day prior to surgery for patients who have stopped Coumadin for the surgery.

BMP: Heart disease, diabetes, kidney disease, diuretic use


Questions regarding preoperative assessment should be referred to the anesthesia department.

 

[MikeMerk-MtS]

Our protocol:

The following is intended as a guide and may be individualized by the attending surgeon and anesthesiologist.
The Department of Anesthesia accepts results of laboratory tests performed within three months prior to the date of surgery.
Tests done prior to three months before the date of surgery may be acceptable at the discretion of the surgeon and anesthesiologist.
ECG interpretations are acceptable up to one year prior to the date of surgery if no changes have been noted in the patient’s cardiac status.
Pregnancy Testing: Females after onset of menses, who have not undergone a sterilization procedure, will be required to complete a urine pregnancy test on the day of surgery. A consent (Attachment C) for pregnancy testing will be signed by the patient (or guardian). Refusal of pregnancy test will lead to case cancellation.

Pre-anesthesia testing is not required for any patient scheduled for low risk procedures scheduled under Monitored Anesthesia Care.

Preoperative testing, (other than pregnancy testing as described above), is not required for any healthy ASA 1 patient.


For patients who are having more than a minor procedure under MAC Anesthesia:


EKG: Age >50, history of heart disease, HTN, OSA, Diabetes, pulmonary Disease, BMI >40

CBC: History of anemia, recent chemotherapy, liver or kidney disease, bleeding disorder, pulmonary disease, BMI>40

PT/PTT: Coumadin therapy, liver disease, consider INR on day prior to surgery for patients who have stopped Coumadin for the surgery.

BMP: Heart disease, diabetes, kidney disease, diuretic use


Questions regarding preoperative assessment should be referred to the anesthesia department.

Thanks! Looks like your institution is OK with EKG within 1 year (assuming no changes in medical status in that year). That's what I was wondering. Thanks!

 

[MikeMerk-MtS]

Depends on the surgery and comorbidities.
Plenty of surgeries need nothing.

Yes, that is true. But my question is for those who had an EKG done in the past for a legit reason, how long is that EKG (or labs) good for. I know its case and institution specific, but each institution usually puts out some guideline for max cutoff.

 

[kidthor]

Over the past two days I saw an ENT tympanoplasty where they (the surgeons) order a CMP, coags, CBC, T&S, EKG for a healthy 30 yo,
then for a guy getting an aorto-bifem bypass they (different surgeons of course) order nothing - for a guy with dyspnea on exertion, new onset AFib, and recent acute GI bleed. Of course they complained that I was delaying them too (I mainly wanted to wait to cross blood - ended up giving 8 units).

 

[Velefunt]

Over the past two days I saw an ENT tympanoplasty where they (the surgeons) order a CMP, coags, CBC, T&S, EKG for a healthy 30 yo,
then for a guy getting an aorto-bifem bypass they (different surgeons of course) order nothing - for a guy with dyspnea on exertion, new onset AFib, and recent acute GI bleed. Of course they complained that I was delaying them too (I mainly wanted to wait to cross blood - ended up giving 8 units).

• I'm sorry you work with surgeons like this.

• You're the patient's best line of defense for optimizing presurgical care - good on you.

• Best of luck at your workplace.