Pre-op assessment for patient w morbid obesity
Cardiovascular
Obtain baseline electrocardiogram
Assess blood pressure control
Examine for symptoms or evidence of right or left ventricular dysfunction
Examine for the presence of coronary artery disease
Ensure appropriate preoperative drug administration for any comorbid cardiovascular conditions
Pulmonary
Assess exercise tolerance
Evaluate for symptoms or history of obstructive sleep apnea
Obtain baseline arterial blood gas on room air
Obtain pulmonary function tests if appropriate
Airway
Perform a basic airway exam
Look for evidence of an impaired oral or cervical range of motion
Determine Mallampati score and neck circumference
Inquire about previous difficult mask airway or intubation
Laboratory studies: Obtain electrolytes, blood glucose, and serum hemoglobin concentrations
Gastrointestinal: Premedicate with metoclopramide, histamine H2 blocker, or proton pump inhibitor as needed
Monitoring: Use appropriate size blood pressure cuff (cuff bladder at least 75% of arm circumference)
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