Suggested Investigations based on complexity of surgery and ASA classification.
ASA Classification used in this guide:
ASA 1 | A normal healthy patient |
ASA 2 | A patient with mild systemic disease |
ASA 3 | A patient with severe systemic disease |
ASA 4 | A patient with severe systemic disease that is a constant threat to life |
If Minor Surgery:
ASA 1 | ASA2 | ASA3 or ASA4 | |
Full blood count | Not routinely | Not routinely | Not routinely |
Haemostasis | Not routinely | Not routinely | Not routinely |
Kidney Function | Not routinely | Not routinely | Consider in people at risk of AKI |
ECG | Not routinely | Not routinely | Consider if no ECG results available from past 12 months |
Lung function/arterial blood gas | Not routinely | Not routinely | Not routinely |
If Intermediate Surgery:
ASA 1 | ASA2 | ASA3 or ASA4 | |
Full blood count | Not routinely | Not routinely | Consider for people with cardiovascular or renal disease if any symptoms not recently investigated |
Haemostasis | Not routinely | Not routinely | Consider in people with chronic liver disease
|
Kidney Function | Not routinely | Consider in people at risk of AKI | Yes |
ECG | Not routinely | Consider for people with cardiovascular, renal or diabetes comorbidities | Yes |
Lung function/arterial blood gas | Not routinely | Not routinely | Consider seeking advice from a senior anaesthetist as soon as possible after assessment for people who are ASA grade 3 or 4 due to known or suspected respiratory disease |
If Major/Complex Surgery:
ASA 1 | ASA2 | ASA3 or ASA4 | |
Full blood count | Yes | Yes | Yes |
Haemostasis | Not routinely | Not routinely | Consider in people with chronic liver disease
|
Kidney Function | Consider in people at risk of AKI | Yes | Yes |
ECG | Consider for people aged over 65 if no ECG results available from past 12 months | Yes | Yes |
Lung function/arterial blood gas | Not Routinely | Not Routinely | Consider seeking advice from a senior anaesthetist as soon as possible after assessment for people who are ASA grade 3 or 4 due to known or suspected respiratory disease |
Notes:
Surgery Grades | Examples |
Minor |
|
Intermediate |
|
Major or Complex |
|
Reference:
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