Preoperative Work Up Protocol

• Full blood count, renal, liver, bone profile and coagulation screen.
• Hepatitis screen on all dialysis/renal failure patients.

• Group and crossmatch for 3 units of RCC/ for 6 units if Redo.

N.B: Check if patient requires CMV neg/irradiated blood.

• ECG & Chest x- ray as ordered by doctor PA and lateral.

• M.S.U

• Sputum for C/S if a productive cough is present.

• PFTs especially on thoracic surgery patients.

• Throat and nasal swab for C&S on all Valve patients. Nasal and groin  swab for MRSA on all other cardiac patients – cards to be labelled ‘preop cardiac surgery'. Also swab any excoriated/broken areas on skin. Full MRSA screen on patients transferred from other hospitals.

• All patients > 40 yrs for cardiac surgery to have carotid doppler pre-operatively.

• All patients undergoing VATS please commence Clexane daily pre-operatively.

• All patients undergoing thoracic surgery c/o Mr Alfred Wood please commence prophylactic subcutaneous anticoagulant pre-operatively.

• Pre-operative physiotherapy consultation.

• Record weight and height in kgs/cms

• As near as possible to the time of surgery patients should have chest and leg hair clipped (if necessary).

• Preoperative skin prep as per Infection Control Policy.

• All patients to have a five day course of nasal ointment TDS as per Infection Control Policy commencing the evening prior to surgery.

• Angio film (cine film) to be sent with the patient to theatre.

N.B: Please ensure that Plavix is stopped 7 days prior to surgery (unless emergency).

• Do not give Aspirin/Plavix on the day of surgery.

N.B: All medications to be prescribed prior to administration .

Pre-operative Protocol