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Spinal Anaesthesia for Day Surgery Patients; A Practical Guide 3rd Edition The third edition of this practical handbook for spinal anaesthesia in day surgery now includes the …

Pre-operative Assessment Clinic (POAC)

Some time before your surgery, you will be asked to attend a Pre-operative Assessment Clinic (POAC). The purpose of this is two-fold. It provides a detailed check on your state of health and your suitability for the planned surgery. It is intended to uncover and treat any potential problems and thus prevent unplanned cancellations on the day of surgery itself. It is also an opportunity for nursing staff to provide you with further information about your procedure, what to expect on the day of surgery and how to prepare for it.

Where?

Depending on the hospital and the type of procedure concerned, this may take place at a dedicated pre-operative assessment clinic, in an outpatient clinic, or on a hospital ward. Some hospitals perform the pre-operative assessment over the telephone or via email, which avoids the need for you to go to the hospital.

What Happens at the POAC?

The preoperative assessment involves answering questions. You may also have a physical examination and/or some medical tests. You will also receive a lot of information about your surgical pathway.

The pre-operative staff already have information about you, their questions are to help ensure that any significant changes in your health or medication are picked up. The medical tests may include blood pressure checks, blood tests to check your organs, ECG (a tracing of your heart) and skin swabs.

Sometimes, the assessment reveals a problem - such as a urinary tract infection or high blood pressure - that needs treating before surgery. Should that be the case, your operation is likely to be deferred until the problem has been resolved. POAC staff will liaise with you and your GP as to the best way of sorting out the issue.

POAC - the Time and the Place for Questions

At the POAC appointment, you will have another chance to discuss the planned procedure. This will include information about the type of anaesthetic recommended, how long the procedure will take, and recovery after surgery. You should have the opportunity to ask any questions you may have about your treatment. If you haven't already done so, you may be asked to sign the consent form at this clinic.

The POAC is also the best time to ask questions about the day of surgery itself. Hospitals vary in their guidelines and what they can provide.

Things you may want to ask include:

What to bring on the day of surgery

For example, clothes, dressing-gown and slippers (day surgery units can be cold!), toiletries, medication, specific requirements (things such as gluten-free snacks for afterwards may or may not be available. The POAC is the time to find this out). Don't forget to bring something to read or do (you may be waiting for a few hours). Many hospitals allow mobile phones and tablets but some do not.

Dropping off and picking up arrangements

You are unlikely to be allowed to drive post-operatively. You will therefore need some form of transport to bring you to hospital and collect you afterwards. The availability of hospital transport and the suitability of public transport or taxis should all be discussed at PAC. If a friend or family member is driving you, they may or may not be allowed to stay with you throughout the day.

Fasting

At the POAC, you should be given very clear instructions as to when you should stop eating and drinking on the day of your surgery. There should be a clear hospital policy about food, clear drinks, drinks with milk in, chewing gum and medication. Confusion about these areas can lead to last minute cancellations.

Timing

All the staff appreciate that patients would like to know exactly what time their operation is, how long it will take and how long they - and their companions - will have to stay in hospital. It is important to realise that giving you exact timings is often impossible. Sometimes, it is only possible to let you know if you are on a morning or an afternoon list. On the day of surgery itself, the staff will keep you informed as far as they can but it is impossible to know exactly how long each individual procedure will take.