SU10.1-4 | Perioperative Management — Graded Quiz

Correct. Outcome depends far more on the system of care than on operative skill alone, and most preventable surgical harm lives in the perioperative pathway — hence structured risk stratification and safety systems.

Most surgical harm is preventable and managed through the perioperative system of care.

Perioperative management exists because outcome depends on the SYSTEM of care, not operative skill alone, and most surgical harm is preventable across all three phases.

Correct. Sign In occurs before induction of anaesthesia and confirms patient identity, surgical site, procedure and consent (and anaesthetic safety checks).

Sign In (pre-induction) confirms identity, site, procedure and consent.

Sign In is performed before induction and confirms identity, site, procedure and consent. Swab/instrument counts and specimen labelling belong to Time Out / Sign Out.

Correct. Tachycardia with a narrowed pulse pressure and a near-normal systolic pressure is early compensated hypovolaemia — the blood pressure is falsely reassuring and the patient needs prompt assessment.

Tachycardia + narrowed pulse pressure = early haemorrhage; do not be reassured by a normal BP.

Tachycardia plus a narrowed pulse pressure with a still-normal BP signals early compensated hypovolaemia/haemorrhage — not stability. Act promptly.

Correct. Capacity is decision- and time-specific: the patient must be able to understand, retain and weigh the relevant information and communicate a choice. A diagnosis or age alone does not remove capacity.

Capacity = understand, retain, weigh, communicate — for THIS decision, NOW.

Capacity is assessed for the specific decision at the specific time — understand, retain, weigh, communicate. It is neither global nor determined by age or diagnosis alone.

Correct. In a genuine emergency where the patient cannot consent and no valid surrogate is available, life-saving treatment may proceed in the patient's best interests under the doctrine of necessity.

Emergency + incapacity + no surrogate = treat in best interests under necessity.

For an incapacitated patient needing emergency life-saving care with no surrogate, treatment proceeds in the patient's best interests under the emergency/necessity principle — not delayed.

Correct. After scrubbing, gowning and gloving, keep hands above the waist and in front of the body, and contact only sterile surfaces. Anything below the waist or behind is considered non-sterile.

Scrubbed hands stay above the waist, in front, and touch only sterile items.

Sterile technique requires hands kept above waist level and in front, touching only sterile items. Dropping hands below the waist, turning the back to the field, or touching the mask breaks sterility.

Correct. With adrenaline the lignocaine ceiling rises to 7 mg/kg (about 490 mg in a 70 kg adult) because vasoconstriction slows systemic absorption. Plain lignocaine remains 3 mg/kg.

Lignocaine with adrenaline = 7 mg/kg; plain = 3 mg/kg; bupivacaine = 2 mg/kg.

Lignocaine with adrenaline allows up to 7 mg/kg (about 490 mg at 70 kg); plain lignocaine is 3 mg/kg and bupivacaine 2 mg/kg. Always calculate per kg.

Correct. Primary intention is closure of a clean wound with apposed edges (suturing) for direct, rapid healing with minimal scar. Secondary intention leaves the wound open to granulate; delayed primary closure waits a few days.

Primary intention = clean, apposed edges closed for direct healing.

Apposing clean wound edges (e.g. suturing) is healing by primary intention. Leaving a wound open to granulate is secondary intention; closing after a few days is delayed primary closure.