How to Perform a Preoperative Evaluation

A discussion of how to medically assess patients who may be undergoing surgery, including predicting risk of adverse outcomes. The Revised Cardiac Risk Index, MICA score, and the ACS Surgical Risk Calculator are included.
#residency #internship #internalmedicine

[@Sam_1964]

Outstanding presentation. Thank you for your efforts

[@agd712]

Please continue adding to this playlist - incoming intern in July !

[@shail6770]

Excellent video as always. Thank you, Dr Strong.

[@michaelokoye9406]

Thanks a million, Dr. Strong.

[@jeffreykwong8426]

Thanks for this amazing video, Dr. Strong! Really helped me understand the thought process that goes on when I consult medicine for a preop eval! Hope you’re well! :)

[@StrongMed]

Jeffrey! It's nice to hear from you. I'm glad the video was helpful - hopefully watching it means that you won't need to consult medicine in the first place! ;)

[@sunving]

Thank you Dr Strong. Good lecture as always.

[@gman064]

Nice presentation… Thank you.

[@hafizalkaf]

always astonishing presentation. How about lung risk assesment, should we order blood gas analysis routinely? what about active pulmonary TB, should we wait 1-2 weeks like covid? thanks from Jakarta

[@StrongMed]

Personally, I have never once ordered PFTs or a blood gas as part of a preoperative assessment. However - I can easily imagine an anesthesiologist ordering these to provide guidance on intraoperative ventilation. And PFTs in particular, are relevant prior to lung surgery, but at the institutions I've worked out, pre-lung surgery evals are done by pulm and anesthesiology, not hospitalists. I'm not sure how much guidance I can offer re: active pulmonary TB. I'm fortunate that it's never come up, but if it did, it would depend on the urgency of the procedure and I would be highly reliant on the ID consultant's opinion on when the patient was no longer contagious.

[@heathward6171]

Fantastic 10/10

[@DyanaLekha]

Good video

[@mcardio1287]

Excellent

[@NinjaSheepa]

very nice

[@amipurohit5452]

We do 2d echo in all who are elder then 50 irrespective of symptoms 😅

[@shail6770]

Dr Strong, what journals or textbooks would you recommend for someone who is beginning their career as a hospitalist (apart from Harrisons and NEJM) What tools or methods do you use to keep up your clinical knowledge after finishing residency?

[@StrongMed]

I rarely look at NEJM and literally haven't cracked open my admittedly significant outdated version of Harrisons in 15 years (though I just did to check the copyright - 1998!). Excluding preparing teaching materials, the only physical books I look at more than a few times a year are a bound copy of JAMA's Rational Clinical Exam series, and Steve McGee's Evidence Based Physical Diagnosis. You may already be familiar with these resources, but if I wore a white coat or otherwise carried something to the bedside to hold pocket references, I might carry MGH Pocket Medicine (newest edition is scheduled to be published this upcoming September), and the latest Sanford Guide - which is mostly used as an app these days. I don't use apps in the hospital, but UCSF's The Hospitalist Handbook (I think now only available as an app) is supposed to be excellent. As a hospitalist, I find the Journal of Hospital Medicine to be the best and most relevant single journal to read. I don't browse other journals, and only look up articles if I see them discussed on Twitter or if it's directly related to a patient on my service.

[@shail6770]

@@StrongMed Thank you!

[@raj2raj5]

1st