What is the urgency of surgery?
Proceed to the operating room
Determine clinical risk factors which may influence perioperative management and proceed to surgery with appropriate monitoring and management strategies based on the clinical assessment.
If one cannot do optimal preoperative evaluation as a patient departs for emergency surgery, the 2007 ACC guideline reminds one to do risk stratification and risk factor management postoperatively.
Terms suggested by the ACC:
An emergency procedure is one in which life or limb is immediately threatened if not in the operating room within roughly ≤ 2 hours. There is time for very limited or no preoperative clinical evaluation.
An urgent procedure is one in which life or limb is threatened without surgical intervention, yet there is time for a limited clinical evaluation in order to optimize perioperative and postoperative course, typically between 2 and 24 hours.
A time-sensitive procedure is one in which a delay of up to 3 months allows preoperative evaluation and management without negatively affecting outcome.
An elective procedure is one which can be delayed to permit complete evaluation and definitive management of conditions which optimize the patient for non-cardiac surgery.