Facing surgery can be a frightening experience fraught with questions, doubts and uncertainties. Good pre-surgery care, helping patients to feel less anxious and making sure their individual needs are met, means they have a better experience and faster recovery. Preparation of surgery depends on your diagnosis. Your physician will discuss with you how to prepare for surgery. Planning ahead can help ensure you have a successful procedure and heal faster with a smooth recovery.
There are several steps you should take before your surgery so you’ll feel as relaxed and confident as possible.
Surgical Patient Checklist : Surgical care has been an essential component of health care worldwide for over a century. As the incidences of traumatic injuries, cancers and cardiovascular disease continue to rise, the impact of surgical intervention on public health systems will continue to grow.
WHO has undertaken a number of global and regional initiatives to address surgical safety. Much of this work has stemmed from the WHO Second Global Patient Safety Challenge “Safe Surgery Saves Lives”.
Before induction of anesthesia : These safety checks are to be completed before induction of anesthesia in order to confirm the safety of proceeding.
The checklist coordinator may complete this section all at once or sequentially, depending on the flow of preparation for anesthesia. The details for each of the safety steps are as follows:
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Has the patient confirmed his/her identity, site, procedure and consent? : The Checklist coordinator verbally confirms the patient’s identity, the type of procedure planned, the site of surgery and that consent for surgery has been given. When confirmation by the patient is impossible, such as in the case of children or incapacitated patients, a guardian or family member can assume this role.
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Is the site marked? : The Checklist coordinator should confirm that the surgeon performing the operation has marked the site of surgery (usually with a permanent felt-tip marker) in cases involving laterality (a left or right distinction) or multiple structures or levels (e.g. a particular finger, toe, skin lesion, vertebra).
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Is the anesthesia machine and medication check complete? : The Checklist coordinator completes this next step by asking the anesthetist to verify completion of an anesthesia safety check, understood to be a formal inspection of the anesthetic equipment, breathing circuit, medications and patient’s anesthetic risk before each case.
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Is the pulse oximeter on the patient and functioning? : The Checklist coordinator confirms that a pulse oximeter has been placed on the patient and is functioning correctly before induction of anesthesia. In urgent circumstances to save life or limb this requirement may be waived, but in such circumstances the team should be in agreement about the necessity to proceed with the operation.
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Does the patient have a known allergy? : The coordinator should ask whether the patient has a known allergy and, if so, what it is. If the coordinator knows of an allergy that the anesthetist is not aware of, this information should be communicated.
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Does the patient have a difficult airway/aspiration risk? : The Checklist coordinator should verbally confirm that the anesthesia team has objectively assessed whether the patient has a difficult airway. If the airway evaluation indicates a high risk for a difficult airway (such as a Mallampati score of 3 or 4), the anesthesia team must prepare against an airway disaster.
The risk of aspiration should also be evaluated as part of the airway assessment.
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Does the patient have a risk of >500 ml blood loss (7 ml/kg in children)? : In this safety step, the Checklist coordinator asks the anesthesia team whether the patient risks losing more than half a liter of blood during surgery in order to ensure recognition of and preparation for this critical event.
Large volume blood loss is among the most common and important dangers for surgical patients, with risk of hypovolaemic shock escalating when blood loss exceeds 500 ml (7 ml/kg in children). Adequate preparation and resuscitation may mitigate the consequences considerably.
Unless your surgeon gives you different instructions, please prepare yourself for outpatient surgery using this checklist.
Two Days or more before surgery :
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Check insurance coverage.
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Have pre-admission tests, such as blood work and x-ray, completed.
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Arrange for a responsible adult to drive you home and stay with you for 24 hours after discharge.
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If you develop a cold or any other illness prior to your surgery, report this to your physician.
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If applicable, bring a copy of legal guardianship papers or Advance Directives.
Day before surgery :
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Avoid smoking, alcoholic beverages, and non-prescription drugs.
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Only take your medication the morning of surgery if instructed to do so.
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You may receive a phone call from a nurse to briefly review your health history and post-operative instructions to include home care needs specific to your surgery.
The evening before surgery :
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Eat a light meal.
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Drink non-alcoholic beverages as desired.
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Prepare anything you will need to bring to the hospital.
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Perform any pre-operative preparations ordered by your physician.
After midnight :
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Do not eat or drink anything unless your physician specifically orders medications or clear liquids.
The day of your surgery :
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Leave jewellery, money, and other valuables at home.
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Bring your insurance identification card.
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Bring a container to store your contact lenses or glasses.
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Bring reading materials, knitting, etc. in case of delays.
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Wear loose comfortable clothing.
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Plan to arrive at the Outpatient Department at your assigned time. This time is approximately one and a half to 2 hours prior to your surgery.
After surgery :
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Do not drive a car, operate complex machinery, drink alcoholic beverages, or take medications without physician orders.
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Postpone important decisions and signing of important papers for at least 24 hours.
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You will need a responsible adjust to drive you home and stay with you for 24 hours.
There are several steps too which you should take before your surgery so you’ll feel as relaxed and confident as possible. Start with answering these questions:
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Are your physicians qualified?
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Is the facility licensed and accredited, and are emergency procedures in place?
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Who will provide the anesthesia?
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Am I as healthy as I can be?
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How do I avoid surprise medical bills?
