Page 48 - 2021 KBI Portfolio Brochure

LUTHERAN MEDICAL CENTER
P.O.C.O BRAND IDENTITY MEDICAL DESIGN
Use LutheranVista to Order a Poco Consult, YOU MUST ALSO CALL THE HOTLINE AT 718-630-POCO (7626)
PRE-ANESTHESIA TESTING GUIDELINES
Pre-Operative Conditions
Test Validity Time Frames
Age > 50
Age > 70
Females of Childbearing age
Major Surgery (EBL > 200 ml, AAA, major vascular, total joint, thoracic, bowel, liver, bariatric, pancreatic, laparotomy, etc.)
CBC
4 wks
*
PT/PTT
4 wks
Chem 8
4 wks
*
6 mo
ECG
*
**
on & Optimization (POCO
Pre-Operative Consu
)
Hypertension
l
t
*
D
i
i
*
ab
et
a
t
e
s
*
Coronary Artery Disease * * service must be called for all inpatients with
*
CXR
Other/Comments
*
6 mo
For change in condition or active issues re-test within 1 week
UCG on DOS
*
Type and Screen within 6 days (for PST patients)
Chem 8 if on meds
CHF ** Arrhythmias *
*
anticipated surgical procedures
*
*
Smoker (1PPD x 20 yrs, ex <10) years *
Symptomatic Pulmonary Disease
(Restrictive /Obstructive, Mass)
Use LutheranVista to Order a POCO Consult,
*
*
ESRD * ** YOU MUST ALSO CALL THE HOTLINE AT
*
**Plasma K+ DOS
Clinically Hepatic Disease/Previous 718-6D3x0ET-OPHOAbCuseO (7626)
Bleeding Disorder
***
* *
Decrease * post-op
complications
and improve *
* *
*
*
**Liver Function Panel
BMI > 35
GOALS OF THE PROGRAM
*
Improve preoperative optimization and risk stratification
Ensure proper pre-operative testing using evidence-based guidelines and standards
ReAdnuecemia
unnecessary
Improve operational efficiency by
Decrease lenghth
testing and
BP Meds/Diuretics /Cardiac Medsof stay
avoiding consultation delays and
outcomes
*
**
**CXR for age 50 or over
**with platelet count
**within 2 weeks for Active Anemia
Anticoagulants
cancellations
Steroids
*
Chemotherapy
DEPARTMENT OF ANESTHESIOLOGY
Active radiation to chest/neck * Lithium
*
*
*
Except Antiplatelet Meds
ECG only if on Adriamycin
Please note: Additional tests should be ordered at the discretion of the practitioner as
needed to address specific medical or surgical issues.
TESTING GUIDELINES
GOALS OF THE PROGRAM
• Improve preoperative optimization and risk stratification
• Ensure proper pre-operative testing using evidence-based guidelines and standards
• Reduce unnecessary testing and consultation
• Improve operational efficiency by avoiding
surgery delays and cancellations
• Decrease length of stay
• Decrease post-op complications and
improve outcomes
TO REQUEST POCO CONSULTATIONS
• Identify patients for surgery / procedure
• Perform basic testing per Pre-Anesthesia Testing
(PAT) guidelines
• Order POCO consult via LutheranVista
• Call POCO Hotline at 718-630-POCO (7626)
• Patient is medically optimized
• Medical/cardiac workup needed
• Medical optimization needed (i.e. fluids, electrolytes,
transfusion, insulin)
• Consider alternate therapies (i.e. RT, palliation)
or alternate approaches (i.e. staged procedure,
interventional radiology)
• Modify location of care (i.e. admit to ICU for
optimization)
• Plan intra-operative monitoring
• Recommend postoperative plan
Physician Guide
Pre-Operative Consultation & Optimization (POCO) service must be called for all inpatients with anticipated surgical procedures
Use LutheranVista to Order a Poco Consult, YOU MUST ALSO CALL THE HOTLINE AT 718-630-P-O-C-O (7626)
POCO and PAT Guidelines are available:
• Physician’s Portal: https://portal5.lmcmc.com • Intranet: PreOp-POCO/PAT
D E P A R T M E N T O F A N E S T H E S I O L O G Y
POSSIBLE FINDINGS / RECOMMENDATIONS RESULTING FROM POCO CONSULTATION
KIM BROWN IRVIS CREATIVE DESIGNER 46 WWW.KBIDESIGNGROUP.COM
POCKET GUIDE
DRAFT