Elizabeth A. M. Frost MD Dept of Anesthesiology Icahn Medical Center at Mount Sinai. Why Bother! Pre-op Testing. On Chloroform and Other Anaesthetics. (1858).
“On feeling the pulse of a 21 y/o…I found it to be small, weak, and intermitting. I told the patient he had nothing to apprehend. His pulse improved. He inhaled the chloroform, His teeth were extracted. He woke up. Now, if the inhalation had commenced without inquiry, the syncope would have had the appearance of being caused by the chloroform” pp 77-8 John Snow.
(the start of fee splitting ???)
(Roizen, Can J Anaesth 1989)
Proceedings of the 4th Annual Perioperative Medicine Summit: Cleveland Clinic 2009: suppl 4 Vol 76.The role of testing in the preoperative evaluation
Practice Advisory for Preanesthesia Evaluation: ASA Oct 2011; Anesthesiology 2012 (with 173 references)
American College of Cardiology/American Heart Association, European Society of Cardiology. Updated guidelines (Schiefermueller J et al Angiology 2012: May 3rd)
Preanesthesia Evaluation for ambulatory surgery; Hofer J. Curr Opin Anaesthesiol 2013; 26(6): 669-76
Emphasis on preoperative clinical risk stratification
AND THEN THERE IS A SURGICAL OPINION
1. Siriussawakul A et al Biomed Res Int 2013: 2013:835426, 2. Czoski-Murray C Health Technol Assess 2012; 16(50): i-xvi, 1-159, 3. Bohmer AB Anaesthetist 2014; 63(3): 198-208, 4. Maher JL Can J Plast Surg 2012; 20(3): e32-4, 5. Benarroch-Gampel J Adv Surg 2013; 47; 81-98
Let’s (Not) Get Physicals
We cling to the ritual of the annual exam, despite evidence that it isn’t needed.
Jettison EKG, chest X-ray, blood work for healthy people.