Preoperative Assessment Clinic (PAC)
Dr. Forest, Director of PAC
The Preoperative Assessment Clinic, an outpatient clinic of Wake Forest Baptist Health, provides preoperative evaluation, preparation, and education for over 16,000 outpatients and same-day surgery patients each year.
We have two locations to serve our patients’ needs.
The Department of Anesthesiology provides staff for each clinic. Included in this group are receptionists, pharmacy technicians, nurses, physician assistants, nurse practitioners, and a nurse anesthetist dedicated solely to preoperative patient preparation. Anesthesiology interns and residents participate in preoperative assessments by performing histories and physical examinations. These physicians provide patients with up to date information regarding their anesthesia and surgery.
While the PAC routinely prescreens, obtains lab data, and noninvasive cardiac and pulmonary tests, these studies are not a mandatory part of the preoperative process. You may receive a phone call from PAC staff after your surgery is scheduled, to ask you a few questions about your health and surgery history, and to determine whether a visit to the Preoperative Assessment Clinic is necessary prior to your procedure. If you have basically good health and are having a minor procedure, the preanesthetic evaluation MAY be safely completed on the morning of your surgery, by your anesthesiologist. If you are scheduled for a PAC visit, you will undergo a history and physical examination by the PAC staff, and the decision to obtain further tests will be based on your individual health relative to your upcoming surgical procedure. Such decisions require direct collaboration between the patient’s primary care physician, anesthesiologist and surgeon. We take great pride in our collaborative efforts to ensure successful outcomes for our patients.
We have a variety of consultants available for our more complex patients. For those who require invasive testing, we coordinate this during the PAC appointment. We have an electronic medical record (EMR) that communicates directly with our intraoperative anesthesiologists, nurses, and surgeons. Our EMR facilitates immediate communication between medical care providers and maximizes our patients’ experience.
At the completion of the your visit, our nurses verify correct documentation and obtain electronic signatures on consent forms. Our staff provide detailed instructions to prepare you for your upcoming surgery. For this to occur, we request that you allow 90 minutes for your thorough evaluation. Such time is necessary to complete all documentation, review preoperative instructions, and ensure patient readiness for surgery.
To expedite the PAC visit, many patients find it helpful to have completed the PAC intake form prior to arrival. The form is also available in Spanish. The PAC intake questionnaire reviews past medical/surgical history, current medications, and allergies and asks questions pertinent to potential medical issues that may not have been previously evaluated.
Please bring the following with you to your appointment:
- a list of current medications (doses and instructions)
- completed PAC Intake form
- details of your past medical history
- surgical procedures
- cardiac devices (pacemakers, ICD’s)
- implants that may have been placed
As part of the PAC visit, we will discuss medical management issues and medication instructions. Certain medications may need to be carefully discontinued before surgery. It is important to coordinate medication changes with both your surgeon and anesthesiologist. For example, it is important to inform the PAC if you are taking blood thinners (Plavix, Aspirin, Coumadin, or Lovenox), antibiotics, Diabetes or heart medications. These medications may sometimes be continued through surgery. Your surgeon and anesthesiologist will likely need to discuss with your medical doctor when to stop and restart these drugs. If you have a pacemaker or ICD, you will be seen by 2 members of our cardiology device clinic so that the appropriate evaluation may occur. These devices are managed differently depending upon the medical reason for the device and type of surgery. Lastly, please visit our patient resources as you will find many helpful maps, guides, and information to assist your preparation for surgery.