Summary of Key Points for OSCEs
Having an anaesthetic and undergoing surgery represents a major physiological challenge for the human body. The preoperative assessment is designed to anticipate any problems that might be encountered in the perioperative period and to take steps to minimise their impact as much as possible. In the emergency setting, this is not always achievable, but in designated pre-assessment clinics, patients who are scheduled for elective procedures can be ‘optimised’ to a large extent before the operation.
Pre-assessment clinics are increasingly nurse-led, but in many NHS trusts the surgical FY1 carries out the pre-assessment for their consultant’s lists a few weeks in advance. If you get a preoperative assessment in the OSCE, it is almost certain that you will see a patient for an elective procedure.
The ASA Classification
The American Society of Anaesthesiologists has developed ‘grades’ to classify patients in terms of their general fitness for anaesthesia (see the table).
| ASA grade | Description |
| 1 | Normal, fit, healthy patient |
| 2 | Patient with mild systemic disease |
| 3 | Patient with severe systemic disease |
| 4 | Patient with severe systemic disease that is a constant threat to life |
| 5 | Moribund, not expected to survive more than 24 hours |
| 6 | Brainstem death, organ donation |
| E | Suffixed to any grade, E indicates an emergency operation, e.g. 1E, 2E, etc. |
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