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Preoperative assessment

Before having an operation, you will be seen in the Pre-Operative Assessment Clinic (POAC). This is on level 6 in the Bristol Royal Infirmary building. This is a nurse-led service with supervision and input from the anaesthetic department.

Who will I see?

The POAC is nurse-led, so you will first be seen by a trained nurse. If you are having major surgery, or you have significant other medical conditions (such as heart failure or major lung problems), you may also be reviewed by an anaesthetist.

What will they ask me?

The healthcare professional who sees you will ask you about the surgery you are having, as well as any other medical conditions, any medications you take and any allergies you may have. You will also be asked about your social circumstances, and whether you smoke or drink alcohol.

What advice will they give me?

You will be given advice about preparing yourself for your operation, if and when you need to stop taking any of your medications before your operation, and instructions for eating and drinking before your operation.

If you are having day case surgery (when you will go home the same day as your operation), you will be given advice about going home, as you will usually need someone to pick you up and accompany you overnight.

If you are having will be in hospital overnight, or for several days, the team will be able to tell you more about what to expect after your operation.

Will I have any tests?

You may have a variety of tests while at POAC. These may include:

  • Blood tests
  • An ECG (electrocardiograph). This involves sticky pads being placed on the chest and provides a trace of the electrical activity of the heart.
  • An echocardiogram. This is an ultrasound scan involving jelly and a hand-held device being placed against the chest over the heart to get more information about how the heart if functioning. It is not invasive, and does not involve any radiation exposure.
  • CPET (Cardio-Pulmonary Exercise Testing). This involves being connected to an ECG machine and having a face-mask on to monitor you while you walk on a treadmill which is steadily inclined. This tests how your body responds to increasing workloads, which helps understand how your body will cope with the stress of surgery.
  • Stress echocardiogram. This is an echocardiogram that is done while a medication is also given to mimic the effects of exercise on the heart. This is done under the supervision of a doctor.

These tests are done as part of a broad assessment to make sure you have surgery in the safest possible way, and that you and the clinical team understand the risks involved as clearly as possible.