preanesthesiaassessment课件

,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,#,Preanesthesia assessment,术,前,评估,理想麻醉,要求,什么是理想麻醉？,理想麻醉,要求,平安,无痛,精神安定,适当肌松,麻醉方式有哪些,？,全身麻醉,局部麻醉,吸入性麻醉,静脉麻醉,表面麻醉,局部浸润麻醉,神经阻滞麻醉,椎管内麻醉,蛛网膜下腔,硬膜外腔,PAME,PAME,PAME,：,Preanesthetic,Medical Evaluation,Apply,to all patients undergoing sedation or any type of anesthesia for a procedure,.,To assure patients are appropriately prepared for procedures completed under sedation or any type of anesthesia,.,PAME,An anesthesia care plan is,based upon:,Reviewing,the medical record.,Interviewing,and examining the patient to:,Discuss,the medical history,previous anesthetic experiences and drug therapy.,Obtaining,and/or reviewing tests and consultations necessary for appropriate anesthesia care.,Determining,the appropriate prescription of preoperative medications as necessary to the conduct of anesthesia.,The,anesthesia,provider shall verify that the above has been properly performed and documented in the patients electronic medical record.,When,does,PAME occur,?,PAME,Patients,who are healthy,on minimal medications,with minimal medical problems,can have this occur on the day of the planned procedure,immediately prior to the procedure by the anesthesia provider responsible for the patient.,All,other patients need preoperative evaluation before the day of the procedure.,What,does,PAME include?,PAME,Height,(cm),weight(kg),and vital signs,Review,of systems,Annotated,active problem list,Review,of medications and allergies,Focused,physical exam of airway,heart and lungs,Family,history,Ordering,of any needed tests,Routine,laboratory and radiographic tests such as chest x-ray,CBC,Type and Screen or Crossmatch are required only if specifically indicated.,How long,is PAME“good?,PAME,It depends on requirements of different medical institutions,Whenever,possible,the Medical Examination should be scheduled at least 3-5 clinic days prior to surgery.This is to allow time for often necessary testing,consultation and follow-up visits,.,PAME,These,evaluations are valid until something changes in the patients situation:,New,medications or change in dosages,New,medical problem,Change,in existing medical problem,hospitalization,Recent,operation,ASA,麻醉前评估,-,ASA,分级,美国麻醉师协会,(ASA),根据病人体质状况和对手术危险性进行分类，于麻醉前将病人分为,6,级：,麻醉前评估,-,ASA,分级,NPO,NPO,NPO,Guidelines apply to all patients,adult and pediatric,undergoing sedation or any type of anesthesia for procedures.,Adult NPO Guidelines(2-6-8 Rule,),Pediatric NPO Guidelines(2-4-6-8 Rule),NPO-,Adult NPO Guidelines(2-6-8 Rule,),8,hours before,your scheduled procedure:,Stop,eating solid food.,Continue,drinking liquids.,Do,not use tobacco products or e-cigarettes.,Do,not take vitamins or supplements.,6,hours before:,Stop,drinking any non-clear liquids(such as milk or orange juice).,You,may continue drinking clear liquids such as water,clear fruit juice(such as apple or white grape;,no,orange juice),carbonated beverages,clear tea or black coffee(,no,milk or creamer;sweeteners are allowed).,If,you are on tube feedings,stop tube feedings.,2,hours before:,Stop,drinking anything.,May,take a sip of water with medications as instructed.,NPO-,Pediatric NPO Guidelines(2-4-6-8 Rule),8 hours beforeyour scheduled procedure:,Stop,giving your child any solid food.,Encourage,your child to drink liquids.,6,hours before:,Stop,giving your child any non-clear liquids such as formula or milk.,You,may continue to give breast milk.,Encourage,your child to continue to drink clear liquids such as water,clear fruit juice such as apple or white grape(noorange juice),or carbonated beverages.,If,you are on tube feedings,stop tube feedings.,4,hours before:,Stop,giving breast milk.,Continue,to encourage your child to drink clear liquids.,2,hours before:,Stop,giving your child anything to drink.,hanks！,谢谢！,T,