Medical clearance is standard form not tailored to individual: H&P, CBC, & CMP (30 d), EKG (6 mo), Cardiac Clearance if applicable. Patient age >60, no heart issues, exercise tolerance high (e.g cardio 860 calories in 65 min). All specialty societies recommend against routine ECG. One study cited in ACC/AHA guidelines found 20% false positives in asymptomatic individuals undergoing pre-op ECG. Does anyone have any insight into why pre-op testing is necessary when patient objects?
Answer: Pre-admission testing Thanks for your question! Most places do have a standard protocol for pre-admission testing which is often dictated by whomever is administering anesthesia. I would just look at it as an extra precaution to keep you safe. Also, ask with your specific plastic surgeon why he/she has this recommendation in place. Good luck!
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Answer: Pre-admission testing Thanks for your question! Most places do have a standard protocol for pre-admission testing which is often dictated by whomever is administering anesthesia. I would just look at it as an extra precaution to keep you safe. Also, ask with your specific plastic surgeon why he/she has this recommendation in place. Good luck!
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May 12, 2017
Answer: Clearance should be based on what is appropriate for a given individual based on their medical history. Age is one of those elements in the history. Having a baseline EKG is very helpful to use as a basis for comparison to determine if an abnormal EKG at the time of surgery is a new change in the EKG or something that was previously present. Yes, there is always the risk of false positive or negative tests. However, routine screening prior to surgery can be very helpful in advance of elective surgery. It is hard to argue about getting a CBC prior to surgery where you have a risk of loosing blood. You did not get a chest X-ray, which was once part of routine testing. The History and physical is essential, and the CMP (comprehensive metabolic panel) helps identify other issues that might be present but asymptomatic. Hope that helps.
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May 12, 2017
Answer: Clearance should be based on what is appropriate for a given individual based on their medical history. Age is one of those elements in the history. Having a baseline EKG is very helpful to use as a basis for comparison to determine if an abnormal EKG at the time of surgery is a new change in the EKG or something that was previously present. Yes, there is always the risk of false positive or negative tests. However, routine screening prior to surgery can be very helpful in advance of elective surgery. It is hard to argue about getting a CBC prior to surgery where you have a risk of loosing blood. You did not get a chest X-ray, which was once part of routine testing. The History and physical is essential, and the CMP (comprehensive metabolic panel) helps identify other issues that might be present but asymptomatic. Hope that helps.
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Answer: Routine lab/EKG prior to elective lid surgery Dear Bob F,
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Answer: Routine lab/EKG prior to elective lid surgery Dear Bob F,
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May 12, 2017
Answer: EKG requirement question Hello Bob F and thank you for your question. I agree that nearly all recommendations are against routine EKG in the absence of other risk factors (cardiovascular disease or other anesthesia risk factors). That being said, with large numbers of patients coming through a surgery center, it is often easier to issue a standard protocol - which is likely the case. Ultimately, it is a conversation that should be had with your physician and yourself and proceed on terms with which you are both comfortable. Best of luck!
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May 12, 2017
Answer: EKG requirement question Hello Bob F and thank you for your question. I agree that nearly all recommendations are against routine EKG in the absence of other risk factors (cardiovascular disease or other anesthesia risk factors). That being said, with large numbers of patients coming through a surgery center, it is often easier to issue a standard protocol - which is likely the case. Ultimately, it is a conversation that should be had with your physician and yourself and proceed on terms with which you are both comfortable. Best of luck!
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May 12, 2017
Answer: Lab work for blepharoplasty This issue is a frequent topic of conversation between surgeons and anesthesiologists. While the current trend is away from pre op lab work and EKGs in asymptomatic patients, many Anesthesiologists prefer a baseline EKG and labs for patient safety. In my practice we individualize the need for pre op lab work and EKG based on history and age in consultation with the Anesthesiologist. I would emphasize that this is done for your safety and I would hope that you view it that way. I would discuss it with your surgeon.
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May 12, 2017
Answer: Lab work for blepharoplasty This issue is a frequent topic of conversation between surgeons and anesthesiologists. While the current trend is away from pre op lab work and EKGs in asymptomatic patients, many Anesthesiologists prefer a baseline EKG and labs for patient safety. In my practice we individualize the need for pre op lab work and EKG based on history and age in consultation with the Anesthesiologist. I would emphasize that this is done for your safety and I would hope that you view it that way. I would discuss it with your surgeon.
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