Preoperative assessment of the ambulatory patient

Whenever the human body is subjected to anesthesia and an invasive surgical procedure, the potential for complications exists. A goal of perioperative care is to minimize that risk while providing the safest care available for the patient. Initial steps toward accomplishing this goal include (1) conducting a thorough preoperative assessment of the patient's medical, surgical, and anesthetic history; (2) performing a physical examination; and (3) procuring and interpreting the results of necessary diagnostic procedures and laboratory evaluations. The increased use of ambulatory surgical services, coupled with changes in health care economics, dictates reform in patient evaluation before surgery. The evaluative process must be cost-effective and efficient without compromising reliability. This article familiarizes and updates the perianesthesia nurse on management issues for the surgical patient.