- Assessment of physiological reserve
- Indications for common surgical procedures and their urgency
- Perioperative medication management
- Preoperative risk assessment, risk scores, and their interpretation
- Principles of anaesthetic care
- Principles of preoperative medical optimisation
- Relevant society guidelines regarding perioperative management of adult patients
- Risk factors for postoperative adverse outcomes and their prevention / management
Comprehensive preoperative assessment
- Advanced care planning
- Anaemia and optimising haemoglobin
-
Assessment of:
- cardiovascular risk
- complex comorbidities
- delirium and its prevention
- fall risk
- frailty
- functional capacity
- nutrition, such as malnutrition and obesity nutritional assessment tools, such as:
- Malnutrition Universal Screening Tool (MUST)
- Subjective Global Assessment (SGA)
- Comprehensive geriatric assessment
- Consideration of surgical indication and urgency
- Fluid and electrolyte status and acid-base disturbance
-
Management of common high-risk medications, such as:
- anticoagulants
- diabetic medications, including insulin
- immunosuppressants, including steroids
- Medication review and assessment, including medications to be discontinued or dosage-modified perioperatively
- Medications with high risk of withdrawal syndromes, such as alcohol and opioids
- Pain management
- Previous anaesthetic history and complications
- Principles of informed consent
-
Risk assessment tools, including:
- Duke Activity Status Index (DASI)
- National Surgical Quality Improvement Program (NSQIP)
- Shared decision-making processes and support, including risks and benefits of surgical and non-surgical management
- Utility of preoperative investigations
- Adrenal crisis
- Assessment prior to emergency surgery
- Autonomic instability
- Blood loss conservation, and indications for transfusion
- Elective surgical planning
- High-risk bleeding and thrombosis
- High-risk cardiovascular disease
- Marginal surgical candidates
- Patients who would benefit from prehabilitation and rehabilitation
- Phaeochromocytoma
- Pituitary surgery
- Pulmonary hypertension
- Thyroid storm
Intraoperative considerations
-
Types of anaesthesia, such as:
- general anaesthetic, including:
- local
- regional
- sedation
- Types of intraoperative monitoring
-
Types of vascular access, including:
- arterial lines
- central venous catheters
- peripheral
Postoperative considerations
- Common postoperative complications, including:
- anaemia
- arrhythmias
- constipation
- delirium and/or other cognitive dysfunctions
- exacerbations of underlying comorbidities
- functional decline
- hypothermia
- kidney injury, acute
- malnutrition, such as:
- micronutrient deficiency, including:
- protein-calorie
- myocardial arrhythmias and injury
- nausea
- respiratory failure, such as:
- aspiration
- atelectasis
- obstructive sleep apnoea
- sepsis
- urinary retention
- venous thromboembolism:
- vomiting
- withdrawal syndromes
- Discharge planning considerations, including rehabilitation
- Enhanced recovery after surgery (ERAS) protocols
- Glycaemic control
- Leading a rapid response call for a deteriorating patient
General management considerations
- Consideration of clinical indications to determine patients’ needs, including comorbidities, and the most appropriate approach to investigations and care
- Consideration of the patient holistically, including cultural background, ethnicity, family and psychosocial support, geographic location, and socioeconomic status, and the considerations when managing and following up these patients, such as community-based decision making and travel from rural to metropolitan areas
- Cost, implications, and scope of healthcare-related adverse outcomes
- Family violence awareness and screening
- Goals of therapy
- Individual patient clinical indications to determine patients’ needs, including comorbidities, and the most appropriate approaches to investigations and care
- Informed consent
- Medication review and polypharmacy management
- Multidisciplinary collaboration throughout patients’ perioperative journeys
- Principles of trauma-informed, patient-centred care
- Relationship between primary care and specialist health services
- Role of allied health professionals in holistic care of patients and families affected by illness
- Tailoring treatment and management to the setting in which care is being provided, such as clinical and workforce resources
