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Perioperative Care

Preoperative Respiratory Assessment

Post-operative pulmonary complications are common after major surgery. At York Teaching Hospital we are committed to providing a full respiratory assessment of our major elective patients. As well as using valuable cardio-pulmonary exercise measures such as ventilatory equivalent ratio for carbon dioxide (or Ve/VCO2) which gives an indication of ventilatory efficiency, we also perform the ARISCAT risk scoring system. Further information on this can be found in our summary sheet.

Incentive SpirometryPatients that are at high risk of pulmonary complications are highlighted to the physiotherapy team to be prioritised on the first post-operative day after surgery. They are also provided with an incentive spirometer and life style advice.

Patients that smoke are referred to the SMOKEFREE helplines and webpages. A Fagerstrom Test of Nicotine Dependence is also performed and nicotine replacement therapy prescribed if required.

General Recommendations

  • Early referral to physiotherapy if appropriate.
  • Pre-operative incentive spirometry.
  • Smoking cessation advice and nictoine replacement if required.
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