Vascular Bypass Operations - Fem/Pop/Distal etc.

1. History and examination

2. Non Invasive Vascular lab. ABIs, segmental pressures, toe pressures in all diabetics and also a duplex scan with marking of ipsilateral (or contralateral) veins if using a vein graft

3. Bloods FBC, U&E, Coag screen, GXM (have 2-4 units available), Risk factors, fasting glucose and lipids

4. ECG and CXR

5. Femoral angiogram, +/- old angios. These must be available the morning of theater and go to theater with patient

6. Inform & consent - ensure the correct side is mentioned on the consent & notes, see 11.1.2

7. Mark side of operation, and initial mark, see 14.3.

8. Significant cardio respiratory risks - consult preop

9. Postoperative- antibiotics and anticoagulation as per post-op note. Check Doppler monitoring on ward. ABI on day 2 or 3. Antibiotics should not continue for more than 2 doses unless there is evidence of infection or contamination at procedure

10. Physiotherapy and OT to be consulted. For amputation, social worker, occupational therapy and physiotherapy consult. Dr. Donegan consult for rehabilitation and limb fitting.

These should be sent preop!