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Which Patients May "Bypass" the
Preoperative Anesthesiology Clinic (PAC)?

click here for the most recent memo on this (pdf) file

(File last saved:11/4/04)

Consider the following:

• Always send those patients that have complex medical histories to the Preoperative Anesthesiology Clinic at F6/2.
  
  
• You may consider not sending ONLY ASA I patients with no significant issues and:
  1. No previous significant anesthesia problems by history or chart. No airway problems or past postoperative issues.
  2. No high risk surgery/procedures planned
  3. No specific patient request for more education regarding anesthesia issues
  4. No issues with "standard medical care"- such as blood product refusal
  5. No obvious need for special anesthesia education (i.e. epidural analgesia, fiber-optic intubation, etc.)
  6. No latex allergy, no history of Malignant Hyperthermia, etc.
  7. No significant cardiorespiratory disease, including recent respiratory infection.
  8. No pacemaker/AICD or other implanted electrical device presence
     
     
• Even if the patient has had anesthesia/surgery in the last month --> if the patient has a complex medical history, call us before allowing the patient to "bypass."
• If you have ANY questions at all about the patient, call the Preoperative Anesthesiology Clinic!
  
  
• Always give patients the Anesthesia Preop Questionnaire [Adult- UWH 4006359, Child- UWH 4006358] to fill out before leaving the Clinic. Review the answers to confirm that the patient does not need to visit the APC. Give the patient a copy of the appropriate "Anesthesia Information Booklet."
  [Adult, Child-FDS, Child-OP].
  

You need to understand that when patients do NOT come through the Anesthesia Clinic, it will take the Anesthesiologist on the day of surgery longer to evaluate the patient between cases (this means turnover time will be increased) , and it can increase the risk that the patient has an issue which will result in case postponement or cancellation.

If you have ANY questions at all about the patient, call the Preoperative Anesthesiology Clinic!