medical history comp

why is taking a thorough medical history important

in case of medical emergency, to know allergies and medications

benefits of having a patient sign their medical history HIPPA and consent form

it’s their legal acknowledgement that the information they have provided is accurate

why is it essential to not only know the names of medications but also possible side effects

to know how their eliminated from the body which is a concern for anesthetics, to know if the disease is well controlled, and to recognize variations intraorally

bradypnea

<12 respirations

tachypnea

>20 respirations

brady cardia

< 60 bpm

tachycardia

>100 BPM

elevated BP

120-129/ less than 80

Stage 1 hypertension

130-139/ 80-89 (and/or)

stage 2 hypertension

140 or higher/90 or higher (and/or)

hypertensive crisis

>180/>120 (and/or)

asa I

normal healthy patient

asa II

patient with mild systemic disease

ASA III

patient with severe systemic disease

ASA IV

severe systemic disease that is constant threat to life

ASA V

moribund patient not expected to survive without surgery

current american heart associations cardiac recommendations for premed

prosthetic heart valve, history of infective endocarditis, congenital heart defects

no penicillin allergy

amoxicillin 2g (50 mg children)

allergic to penicillin (NO history of anaphylaxis to penicillin/ampicillin)

cephalexin 2g (children 50 mg)

allergy to penicilin

azithromycin/clarithromycin 500 mg (15 mg children)

doxycycline

100 mg (2.2 mg under 92 pounds, 100 mg over 92 pounds)

recommendations for premend regarding joint replacement

not recommended anymore, call orthopedist if under 6 months

if pt has congestive heart failure what is the recommended positioning considerations

semi-supine

recommended wait time for pt with myocardial infarction

< 3 months no TX, 3-6 months consult PCP >6 months ok for tx

if pt has an implanted pacemaker/defibrillator what should you be aware of

used for arrhythmias, look at device card see if you can use USS

contraindication for lung disease, ephysema, bronchitis and COPD

USS, chair position

medical conditions that may pose dexterity issues

HX of CVA, multiple sclerosis, parkisons, arthritis, old age

difference between type 1 vs type 2 diabetes

1 is autoimmune, body doesn’t make insulin. Type 2 is insulin, mody doesn’t make enough insulin

normal HBA1c

<5.1%

pre diabetic HBA1c

5.7-6.4

DM II HBA1c

>6.5

effective diabetic Hba1C

6-7

normal blood glucose

70-150

patient with possibility of GERD considerations

semi supine chair position

pt is taking Warafin, what should ask for

INR

effective INR

2.0-3.0

clotting too fast

INR <2

clotting too slow

INR >3

considerations for pregnant pt

no local during first trimester, semi-supine, turn pt to left side due to blocking of inferior vena cava

local anesthesia contraindications

within 24 hours of cocaine, and marijuana use, Stage 2 hypertensive, unstable angina

osteoporosis

normal, due to aging

rheumatoid arthritis

autoimmune

concern associated with anti-resporptive medications/antiangiogenic agents

osteonecrosis of jaw, if delivered via IV risk is much larger

if pt is taking regular corticosteroid therapy, what medical emergency is associated

altered responses to infection+wound healing, adrenal insufficiency.

addisons disease

too little cortisol hormone

cushings disease

too much cortisol hormone

if pt is taking corticosteroids what should be considered

inflammation and immunity are decreased, infection is increased