URTI (Upper Respiratory Tract Infection) / Common coldEdit
Common. Take temperature and ask the patient the following: Hot and shivery? / muscle pains? (signs of systemic viraemia) Cough +/- sputum? (associated chest infection)
Viraemia carries a risk of cardiac involvement with a predisposition to perioperative cardiac arrhythmias (dysrhythmias).
Associated chest infection may worsen with either general or major regional anaesthesia (impaired cough and ciliary escalator). Elective surgery should be postponed.
Apyrexial (<37.5°C) and no muscle pains or cough: probably OK to proceed with surgery.
Note: the prodromal period of many systemic viral illnesses is indistinguishable from the typical short-lived URTI. The patient recovering from major surgery may find this complicated by a developing viral illness.
Either newly discovered, or pre-existing and poorly controlled.
BP should be less than 140/90 to be fit for surgery