Pre-operative Assessment

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1. History

Identify patient risk factors and previous airway challenges through a focused history.

2. Physical Exam

Perform targeted physical examminations and airway assessments to anticipate potential difficulties during anesthesia.

3. Investigations

Understand when and why to order pre-operative tests to optimize airway and anesthesia planning.

1. Pre-Operative History

Video 1

Quick Start Guide

Learn how to take an effective pre-operative history, including the most important questions to ask patients. This video highlights key elements that help identify anesthesia risks and guide perioperative planning.

Video 2

In-Depth Walkthrough

This video covers key tools for pre-operative medical assessment, including the Revised Cardiac Risk Index, MICA score, and ACS Surgical Risk Calculator. Learn how to predict perioperative risk and guide safe surgical planning.

Pre-Op History Checklist

This interactive U of T resource outlines the key components of a preoperative assessment, including history, physical exam, and investigations. A great starting point for safe and thorough anesthesia planning.

Patient Questionnaire

This Ottawa Hospital pre-op health history form provides a structured template for gathering essential patient information before surgery. Useful for ensuring no critical details are missed during assessment.

Detailed Additional Resources

Clinician Oriented Guide

Anaesthesia Collective offers a practical, clinician-oriented guide to preoperative assessment, emphasizing clinical reasoning, risk stratification, and real-world application.

Student Focused OSCE Guide

Geeky Medics provides a student-focused OSCE guide to pre-op assessment with a structured, checklist-based approach. Ideal for exam preparation and early clinical learners.

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2. Pre-operative Physical Exam

General Appearance & Vital Signs

Vitals: blood pressure, heart rate, respiratory rate, temperature, SpO₂
Anthropometrics: height, weight (BMI), nutritional state (cachexia vs. obesity)
Hydration status: skin turgor, mucous membranes

BC Campus Head-to-Toe

Airway Assessment

Mouth opening: inter‑incisor distance ≥ 3 cm
Mallampati score: visibility of soft palate/uvula with tongue protruded, head neutral
Thyromental distance: ≥ 6 cm from thyroid notch to chin
Neck mobility: flexion/extension, cervical spine pathology
Jaw protrusion: ability to advance lower teeth beyond upper
Dentition: loose teeth, crowns, large incisors

Mallampati Score (LITFL)

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3. Pre-operative Investigations

CAS Investigations Guidelines

Discover the 2025 revised Canadian Anesthesiologists’ Society (CAS) guidelines outlining comprehensive pre‑operative investigation practices. This resource offers evidence-based recommendations on when to order labs, ECGs, and imaging

CAS Choosing Wisely Canada

The CAS Choosing Wisely Canada Top 5 list highlights key recommendations to reduce unnecessary tests and interventions in anesthesia care. A practical guide for promoting safer, evidence-based perioperative practices.

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Reviewed and edited by Dr. Isabelle Laksono and Dr. Michael Lee

Anesthesia Curriculum