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Every patient who has surgery at BIDMC receives a pre-op phone call from a PAT nurse as the first step in the perioperative journey. This call usually occurs 1-2 weeks before the scheduled surgery, and generally takes about 10 minutes to complete. The nurse will cover the following topics:
Confirm the type and date of the procedure to be performed
Ask in-depth questions about your medical history, all medications you take, your allergies, previous surgery and anesthesia experiences, and any other medical topics relevant to you or your family. It is critical that you know the names and doses of any medications you take, and the names and contact information for any doctors you see.
Instructions for the day of surgery, including:
What medications to take the day of surgery
When you should stop eating and drinking
You will need an adult to take you home after surgery. This is critical and you will not be allowed to have surgery if you do not have an appropriate ride
Do not bring valuables to the hospital
Special instruction for patients who need them:
How to manage blood thinners
What to do if you have cold or other illness
How to manage a bowel prep for patients having bowel surgery
The second step in the pre-op preparation is a visit to the PAT clinic. While many patients can be prepared for surgery with only the phone call by the PAT nurse, about 35% of patients who come for surgery at BIDMC will be asked to come to PAT. Reasons to come to the clinic include: the need for lab tests or EKG or X-ray, a complex medial history that needs additional review by an anesthesia provider, or the need for a pre-op history and physical. Some patients will see a case manager or physical therapist in PAT.
The visit to PAT generally lasts about an hour. During that time you will likely see a nurse, a technician who will draw your blood or perform an EKG, and a nurse practitioner or anesthesiologist from the Department of Anesthesia who will perform a history and physical exam. They will also talk to you about what to expect from the anesthesia. Again, it is very important that you know the names and doses of any medications you take, and the names and contact information for any doctors you see. The anesthesiologist in PAT will almost certainly NOT be the one who takes care of you for your procedure. You will meet that team on the day of surgery.
The final step in the pre-anesthesia process occurs in the holding area on the day of surgery. There you will meet a pre-op nurse who will check you in, confirm your procedure with you, and review your medical a history. You may also be seen by a nurse practitioner who will place an IV and review your history. You will then be seen by the anesthesia team. This will always include an attending anesthesiologist, and might also include an anesthesia resident or certified nurse anesthetist (CRNA). They will confirm your medical history, perform a brief physical exam, describe the anesthesia you will receive, obtain consent for the anesthesia, and then place an IV and start the anesthesia process. From there you will go to the operating room for your procedure. See the “What is anesthesia” section for more information about that.