Understanding Pre-Surgical Clearances: What You Need To Know

Pre-surgical clearance, also known as medical clearance or preoperative clearance, is a process that authorizes a patient’s readiness for surgery. It involves an evaluation by a clinician to determine if the patient is a suitable candidate for surgery. This clearance is critical to ensure the safety and success of the procedure, and it is not just a formality.

The pre-surgical clearance is a comprehensive assessment of the patient’s overall health, identifying any potential risks and implementing any measures to minimize them if necessary. It’s not just about clearing a patient for elective surgery, but rather ensuring that the patient is healthy enough to undergo the procedure, and to minimize the risk of complications during and after surgery. This process is crucial in enhancing surgery outcomes, promoting a smoother recovery, and reducing postoperative complications.

TGH Urgent Care powered by Fast Track offers efficient and comprehensive pre-surgical clearance services. Our team of skilled healthcare professionals ensures that every patient is thoroughly evaluated and prepared for their upcoming surgery. This process includes a thorough review of the patient’s medical history, a complete physical examination, and necessary diagnostic tests to ensure that the patient is in optimal health for surgery.

The Pre-Surgical Clearance Process

Initial Consultation

The pre-surgical clearance process at TGH Urgent Care starts with an initial consultation. This is a crucial step where our healthcare provider discusses the upcoming surgery with their patient, explains the entire pre-surgical clearance process, and answers any additional questions. It’s an excellent opportunity for patients to voice their concerns and for providers to ensure that patients fully understand what to expect before, during, and after their surgery.

Medical History Evaluation

The next step in the process at TGH Urgent Care is evaluating the patient’s medical history. This involves a thorough review of the patient’s past and current health conditions, previous surgeries, allergies, and medications. This information is vital as it allows the healthcare team to identify any potential risks and prepare accordingly to ensure the safety and success of the surgery.

Physical Examination

Following the medical history evaluation, a comprehensive physical examination occurs at TGH Urgent Care. This includes checking the patient’s vitals such as blood pressure, pulse, height, and weight. The physical exam may also involve other examinations depending on the type of surgery planned and the patient’s overall health status. This examination aims to assess the patient’s current health status and to detect any unrecognized disease or risk factors that may increase the risk of surgery.

Laboratory Tests

Following the physical examination, TGH Urgent Care providers may order laboratory tests. These tests might include a complete blood count (CBC), coagulation profile, or metabolic panel. The laboratory tests offer a detailed view of the patient’s overall health and help identify potential issues that might complicate the surgical procedure.

Imaging Studies

Imaging studies might be needed in some cases as part of the pre-surgical clearance process and could include X-rays, MRIs, or CT scans to visually assessing specific body areas. Such diagnostic imaging can help physicians detect abnormalities that might not be evident during the physical examination. These tests are essential for surgeries involving the musculoskeletal system, heart, lungs, and other internal organs.

Standard Tests in the Pre-Surgical Clearance Process of TGH Urgent Care powered by Fast Track

Laboratory Tests

1. HCG checks for pregnancy in women about to undergo surgery.
2. Urinalysis analyzes urine for the presence of diseases or drugs.
3. Glucose measures blood sugar levels and is particularly important for patients with diabetes.
4. MRSA screening checks for Methicillin-resistant Staphylococcus aureus (MRSA), a bacteria resistant to many antibiotics.
5. HA1c or the glycated hemoglobin test used to monitor the long-term control of blood glucose levels in people with diabetes.
6. CBC or complete blood count (CBC) gives important information about the types and numbers of cells in the blood.
7. BMP/CMP: Basic Metabolic Panel (BMP) and Comprehensive Metabolic Panel (CMP) are blood tests that measure your sugar level, electrolyte balance, kidney function, and liver function.
8. PT/PTT w/INR measure how long your blood can clot.

Please note: additional tests may be ordered depending on the individual’s health history and the type of surgery.

Diagnostic Imaging

1. X-rays: X-rays provide images of the body’s structures, particularly bones.
2. MRIs: Magnetic Resonance Imaging (MRI) provides detailed images of soft tissues such as muscles, ligaments, or blood vessels.

Cardiac Assessment

1. Electrocardiogram (ECG): An ECG measures the heart’s electrical activity and can detect if the heart is functioning normally.
2. Echocardiogram: This test uses sound waves to create detailed images of the heart’s structure and function.

Factors Affecting Pre-Surgical Clearances

Age and General Health Status

Age and general health status are two primary factors effecting pre-surgical clearances with older adults having an increased risk of malnutrition, which can impact ability to recover post-surgery. Similarly, a person’s overall health status, including their nutritional status and physical fitness, can significantly influence the outcome of surgery and recovery.

Existing Medical Conditions

Existing medical conditions such as heart diseases, diabetes, blood clotting or bleeding disorders as well as pulmonary diseases can also play a significant role in pre-surgical clearances. These conditions can increase the risk of complications during surgery and may require additional testing or adjustments in the surgical plan.

Lifestyle Factors

Lifestyle factors such as smoking, alcohol consumption, and level of physical activity can also impact pre-surgical clearances. For instance, smoking can increase the risk of respiratory complications, while excessive alcohol consumption can effect liver function and the body’s ability to clot blood. Regular exercise can improve physical fitness and potentially enhance surgical outcomes. Patients are often advised to quit smoking, limit alcohol, and maintain regular physical activity as part of their pre-surgical preparation.

Risks and Complications without Proper Pre-Surgical Clearances

Increased Postoperative Complications

Without proper pre-surgical clearances, there’s an increased risk of postoperative complications. Such complications can range from infection and excessive bleeding to more severe issues like cardiac decompensation, respiratory failure, acute kidney injury, and more. Pre-existing medical problems that aren’t adequately evaluated before surgery can lead to these complications, which is why a thorough preoperative evaluation is crucial.

Delayed Recovery Time

Proper pre-surgical clearance is also essential to ensure timely recovery after surgery. With it, patients may avoid delayed recovery times. For example, advanced age or certain medical conditions can slow healing if not adequately addressed in the preoperative evaluation. This can lead to more extended hospital stays, increased healthcare costs, and a lower quality of life for the patient.

Potential for Readmission

Patients who don’t receive adequate pre-surgical clearance are also at a higher risk of being re-admitted to the hospital after surgery. This is often due to complications that could have been identified and managed with a thorough preoperative evaluation. These readmissions are costly and can cause significant distress to patients and their families.

Patient’s Role in Pre-Surgical Clearances

Importance of Honesty and Full Disclosure

Patients have a critical role in the pre-surgical clearance, beginning with honesty and full disclosure. Patients must provide a complete and accurate medical history, including all medications, supplements, allergies, and past surgeries or medical conditions. This information is vital in planning safe and effective care. Dishonesty or incomplete information could lead to complications during or after surgery.

Following Pre-Surgical Instructions

Another aspect of the patient’s role is following pre-surgical instructions. These may include instructions on diet and hydration, medication adjustments, and stopping certain habits like smoking or drinking alcohol. Adhering to these instructions can help reduce the risk of complications and promote a smoother recovery.

Understanding the Risks and Benefits

Patients should also strive to understand the risks and benefits of their upcoming surgery. This means asking questions, researching, and discussing concerns with their healthcare providers. By doing so, patients can make informed decisions about their care and have realistic expectations about the surgical outcomes and recovery process.

Frequently Asked Questions