This is the first episode in series #2 (approach to general anesthesia). In this episode, we break down the pre-operative evaluation.

Step 1: Confirm patient identifiers and NPO status
Step 2: Focused anesthetic history

• Review of systems: CV, resp, GI, GU, neuro (Bonus: endo)
• PmHx/PsHx with previous surgical complications - always ask about pseudocholinesterase deficiency and malignant hyperthermia
• Meds/allergies and compliance to medication

Step 3: Focused physical exam

1. Airway assessment
   1. BONES mnemonic + Mallampati score
   2. Mouth open
   3. Thyromental distance
   4. Protrude mandible and bite upper lip
   5. Neck extension/flexion
2. CV exam
3. Resp exam
4. (Neuro exam if indicated)
5. ASA status

Step 4: Discuss risks and obtain informed consent

• Risk to teeth: 1/1000
• Typical risks: postoperative pain, postoperative nausea/vomiting, sore throat

For a more detailed description of the modalities of anesthesia and their indications, refer to Chapter 3 of the Ottawa Anesthesia Primer

Patterson L. Ottawa Anesthesia Primer: Patrick Sullivan. University of Ottawa, Faculty of Medicine. ECHO Book Publishing, 2012. ISBN 978-0-9918009-0-2. Can J Anesth Can d’anesthésie 2013. https://doi.org/10.1007/s12630-013-9997-4

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