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Pre Op 2010 http://www.scribd.com/doc/40813277/Pre-Op-2010#open_download
AAGBI SAFETY GUIDELINE
Pre-operative Assessment and Patient Preparation
The Role of the Anaesthetist
2
Published by
The Association of Anaesthetists of Great Britain and Ireland
21 Portland Place, London, W1B
2 1PY / 37
Telephone 020 7631 1650 Fax 020 7631 4352
Search within document...
info@aagbi.org
www.aagbi.org January 2010
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Membership of the working party

(details correct at the start of the working party process)
Dr R Verma Chairman
Prof M Y K Wee Vice President, AAGBI
Dr A Hartle Council Member, AAGBI
Dr V R Alladi Council Member, AAGBI
Dr A-M Rollin Vice President, Royal College of Anaesthetists
Dr G Meakin President, Association of Paediatric Anaesthetists
Dr R Struthers Consultant Anaesthetist, Derriford Hospital
Dr J Carlisle Preoperative Association representative
Dr P Johnston Vice Chairman, GAT
Mrs K Rivett Patient Liaison Group representative
Mr C Hurley Royal College of Nursing representative
This guideline has been seen and approved by the Council of the
AAGBI.
2 / 37
The working party is grateful to Dr Helgi Johannsson for his contribution
to this guideline.
1
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Contents
1. Recommendations 3
2. Introduction 5
3. Before planned admission 7
4. After planned admission 15
5. After unplanned admission 18
6. Children and young people 19
7. Tests and investigations 22
8. The patient’s perspective 24
References 26
Appendices 29
To be reviewed by 2015. 2 / 37
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© Copyright of the Association of within document...
Anaesthetists of Great Britain & Ireland. No
part of this book may be reproduced without the written permission of the
AAGBI.
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1. Recommendations
This guidance has been designed to help anaesthetists provide
high quality pre-operative assessment services and patient
preparation before surgery. In addition it defines the roles and
responsibilities of anaesthetists both after planned and after
unplanned admissions.
Anaesthetists should assume a central role in the organisation

of pre-operative services that encompass much more than
preparing the delivery of anaesthesia.
The anaesthetist has the skills necessary to assess, optimise and

estimate risk and support patients deciding whether to proceed
with surgery and anaesthesia.
Pre-operative anaesthetic assessment should minimise risk for all

patients as well as identify patients at particularly high risk.
The pre-operative anaesthetic clinic should co-operate with
primary care to achieve these aims.
Skilled nurse practitioners are safe and cost-effective in

preparing patients for anaesthesia and should work closely with
anaesthetists with a special interest in pre-operative assessment
and preparation.
After scheduled admissions, anaesthetists must confirm that

patients have been prepared adequately by pre-operative
services so that anaesthesia and surgery can proceed safely.
Tests performed before surgery should be limited to those

recommended by national and local guidelines and protocols.
2 / 37
Most anaesthetic departments should plan for one consultant
whole-time equivalent to run and manage daily high-risk clinics
with appropriate secretarial support.
3
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Anaesthetic departments must establish clear pathways of

care for unplanned admissions with surgeons, emergency
departments, critical care and theatre personnel.
Special considerations must be given to children and young

people undergoing anaesthesia and surgery.
Operating sessions and the individual anaesthetist’s job plan

must be arranged to allow time for the anaesthetist responsible
for an individual’s care to visit him/her pre-operatively at an
appropriate time before surgery.
In all but exceptional circumstances this should take place in a

designated reception area, dedicated clinic room or in the ward
ensuring privacy and respecting patients’ dignity, and not in the
anaesthetic room.
Clinical Directors for anaesthesia and theatres should work with

appropriate managers to establish comprehensive and integrated
pre-operative assessment facilities and ensure that there is a lead
anaesthetist for pre-operative assessment.
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Pre Op 2010 http://www.scribd.

1 van 37 13/02/11 18:13

AAGBI SAFETY GUIDELINE

Pre-operative Assessment and Patient Preparation

The Role of the Anaesthetist

2 van 37 13/02/11 18:13

Membership of the working party

3 van 37 13/02/11 18:13

4 van 37 13/02/11 18:13

Anaesthetists should assume a central role in the organisation

The anaesthetist has the skills necessary to assess, optimise and

Pre-operative anaesthetic assessment should minimise risk for all

Skilled nurse practitioners are safe and cost-effective in

After scheduled admissions, anaesthetists must confirm that

Tests performed before surgery should be limited to those

5 van 37 13/02/11 18:13

Anaesthetic departments must establish clear pathways of

Special considerations must be given to children and young

Operating sessions and the individual anaesthetist’s job plan

In all but exceptional circumstances this should take place in a

Clinical Directors for anaesthesia and theatres should work with

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