Pre-op assessment

• Pre-Operative Assessment - Do all patients undergoing major surgery need pre-op physiotherapy assessment?

  • no:
  • only patients with increase surgical risk
  • patients undergoing complex or extensive surgery
  • limited evidence to support benefit of pre-op intervention
  • resources and time are also limiting factors
• Factors Increasing Operative Risk:

  • Pre existing lung disease
  • Smoker
  • Incision site (thoracic or upper abdominal)
  • Age
  • Obesity
  • Malnutrition
  • Poor mobility
  • Anxiety, fear, depression, poor motivation
• Role of Pre-Op Assessment:

  • Assess pre-op state of patient
  • Respiratory, mobility, anxiety
  • Explain the surgical procedure
  • Explain role of physio and post-op Rx (medical prescription)
  • Teach ACBT and other post-op Rx/exercises
  • Postural advice, strengthening and ROM, mobility
  • Reassure patient
  • Answer questions / advice
  • Analgesia