01.introduction of peroperative

Definition of perioperative

1. Peri -operative care Tufail Ahmad Demonstrator surgical BS SURGICAL (GOLD MEDALLIST) MPH Training Scientist in Fundamental of biosafety and biosecurity The Agha University Karachi, Pakistan

2. Health care Definition of  health care efforts made to maintain or restore physical, mental, or emotional well-being especially by trained and licensed professionals 

3. Perioperative care Period of the time that constitute the surgical experience, include Pre-operative . Intra- operative. Post – operative Pre-operative care and management :- it is the preparation and management of a patient prior to surgery. It includes both physical and psychologica l preparation

4. Perioperative care Intraoperative care  is patient care during an operation and ancillary to that operation. Activities such as monitoring the patient's vital signs, blood oxygenation levels, fluid therapy, medication transfusion, anesthesia , radiography, and retrieving samples for laboratory tests, are examples of  intraoperative care . Postoperative care  begins at the end of the operation and continues in the recovery room and throughout the hospitalization and outpatient period

5. Basic terminologies and concepts A- In pt. surgery : pt. expected to remain in the hospital fore more than 24 hrs. B- 0ut pt. surgery : ambulatory surgery –same day surgery pt. return to his home in the same day of surgery. A- optional : at the request of pt . as cosmetic surgery . B- Elective : planned the convenience of pt. as removal of cyst

6. Basic terminologies and concepts d- Urgent : required promptly within 24-48 hrs as malignant tumor E- Emergency : Immediately for survival as intestinal obstruction appendectomy

7. Grades of Surgery Grade I (Minor) Excision of a skin lesion or drainage of abscess . Grade II (Intermediate) Tonsillectomy, correction of nasal septum , arthroscopy……. Grade III (Major) Thyroidectomy , total abdominal hysterectomy Grade IV (Major+) Radical neck dissection , joint replacement , lung operations

8. American Society of Anesthesiologists Patient Classification 1 =A normal healthy patient The pathological process for which surgery is to be performed is localized and does not entail a systemic disease. Example: An otherwise healthy patient scheduled for a cosmetic procedure.

9. American Society of Anesthesiologists Patient Classification 2 =A patient with a mild systemic disease A patient with systemic disease, caused either by the condition to be treated or other pathophysiological process, but which does not result in limitation of activity. Example: a patient with asthma, diabetes, or hypertension that is well controlled with medical therapy, and has no systemic sequelae.

10. American Society of Anesthesiologists Patient Classification 3 = A patient with a severe systemic disease that limits activity, but is not incapacitating A patient with moderate or severe systemic disease caused either by the condition to be treated surgically or other pathophysiological processes, which does limit activity. Example: a patient with uncontrolled asthma that limits activity, or diabetes that has systemic sequelae such as retinopathy

11. American Society of Anesthesiologists Patient Classification 4 =A patient with an incapacitating systemic disease that is a constant threat to life A patient with severe systemic disease that is a constant potential threat to life. Example: a patient with heart failure, or a patient with renal failure requiring dialysis.

12. American Society of Anesthesiologists Patient Classification 5 =A moribund patient not expected to survive 24 hours with or without operation A patient who is at substantial risk of death within 24 hours, and is submitted to the procedure in desperation. Example: a patient with fixed and dilated pupils status post a head injury.