Pre-Operative Care Clinic Referral Guidelines

Initial Evaluation

Evaluate patient to determine need for surgery, procedure, or imaging study requiring anesthesia.

Initial Management:

Determine patient will require surgery, procedure, or imaging study requiring anesthesia.

• There is a personal or family history of anesthesia complications 
  • Parents desire to meet with an anesthesiologist ahead of the day of surgery or has family history suggestive of malignant hyperthermia (relative with cardiac arrest, high fever, muscle rigidity around the time of surgery) or other serious complication with anesthesia.
• There is a patient history of difficult intubation with previous surgery
• The patient follows with multiple medical specialists 
• The patient has certain medical conditions, such as: 
  
  • Heart disease, pulmonary hypertension, significant pulmonary disease, cystic fibrosis, home oxygen or ventilator, muscular dystrophy, diabetes mellitus, diabetes insipidus, renal failure, hepatic failure or intestinal disorder, bleeding disorder, intractable epilepsy, sickle cell disease, mitochondrial or metabolic disorder or any other patient who you feel may benefit

A member of the healthcare team submits a POCC referral via electronic order in Cerner. Specialists outside CNH without access to Cerner can submit a POCC referral via email.

• For patients with complex medical histories, disabilities or having extensive surgery, we have found we can best care for them with a visit to our POCC clinic several days to several weeks ahead of the planned surgery. We work with these patients and families to create a thorough care plan to optimize their health before surgery and coordinate care between medical and surgical services.  
• Although many of our patients do have significant medical concerns, we also see patients who have family members with complications with anesthesia or those who have concerns and questions and would like to meet with an anesthesiologist ahead of the day of surgery.