Preoperative Evaluation

Hybrid RAG + Agentic AI for evidence-based risk stratification and perioperative optimization.

Step 1 of 6
Step 1 of 6

Demographics & Basic Information

Patient demographics and basic information.

Patient History of Present Illness (Optional)

Copy relevant patient history from EHR to provide additional clinical context.

Remove all identifiers (names, dates of birth, MRNs) for HIPAA compliance.
This field helps the AI provide more personalized and context-aware recommendations.
Step 2 of 6

Medical History

Medical history and comorbidities for anesthesia risk assessment.

Cardiovascular

Respiratory

Endocrine

Renal & Hepatic

Neurologic

Other Conditions

Recent Imaging Studies

Document recent imaging results relevant to anesthesia planning. Include key findings only.

Step 3 of 6

Medications & Allergies

Please list ALL medications including over-the-counter drugs and supplements.

Current Medications

Include prescription drugs, over-the-counter medications, vitamins, and herbal supplements.

Beta blockers, ACE inhibitors, ARBs, statins, aspirin, etc.

Metformin, insulin, SGLT2 inhibitors (Jardiance, Farxiga), GLP-1 agonists (Ozempic, semaglutide)

Warfarin, Eliquis, Xarelto, Pradaxa, aspirin, Plavix

Drug Allergies

It's critical we know about any drug allergies or adverse reactions.

Social History

This information is confidential and helps us provide safer care.

Step 4 of 6

Functional Capacity Assessment

Physical fitness assessment and sleep apnea screening.

STOP-BANG: Sleep Apnea Screening

Answer YES or NO to each question. A score ≥3 suggests high risk for obstructive sleep apnea.

Snoring: Does the patient snore loudly (louder than talking or loud enough to be heard through closed doors)?
Tiredness: Does the patient often feel tired, fatigued, or sleepy during the daytime?
Observed: Has anyone observed the patient stop breathing during sleep?
Pressure: Does the patient have or are they being treated for high blood pressure?
BMI: Is the patient's BMI more than 35 kg/m²?

Patient BMI: -- kg/m² (auto-calculated)

Age: Is the patient older than 50 years?

Patient age: -- years (auto-calculated)

Neck: Is the patient's neck circumference > 40 cm (16 inches)?
Gender: Is the patient male?
STOP-BANG Score:
0 / 8
Complete all questions to see the score

DASI: Functional Capacity

Answer YES or NO to indicate whether the patient can perform each activity. This helps estimate functional capacity in METs.

1. Can the patient take care of themselves (eating, dressing, bathing, or using the toilet)?
2. Can the patient walk indoors?
3. Can the patient walk a block or two on level ground?
4. Can the patient climb a flight of stairs or walk up a hill?
5. Can the patient run a short distance?
6. Can the patient do light work around the house like dusting or washing dishes?
7. Can the patient do moderate work around the house like vacuuming, sweeping floors, or carrying groceries?
8. Can the patient do heavy work around the house like scrubbing floors or lifting/moving heavy furniture?
9. Can the patient do yard work like raking leaves, weeding, or pushing a power mower?
10. Can the patient have sexual relations?
11. Can the patient participate in moderate recreational activities like golf, bowling, dancing, doubles tennis, or throwing a baseball/football?
12. Can the patient participate in strenuous sports like swimming, singles tennis, football, basketball, or skiing?
DASI Score:
0.0 / 58.2
Estimated Functional Capacity: -- METs
Step 5 of 6

Airway Assessment & Surgical Details

Surgical details and airway assessment information.

Airway Assessment

These questions help predict potential airway challenges. Leave blank if unknown or unable to assess.

Patient opens mouth wide and sticks out tongue. Higher class = potentially more difficult airway.

How wide can the patient open their mouth?

Distance from chin to thyroid cartilage (Adam's apple)

Heavy beards can make mask ventilation challenging

Family History of Anesthesia Complications

Critical for identifying genetic risks like malignant hyperthermia.

Rare genetic disorder causing life-threatening reaction to certain anesthetics

Genetic condition causing prolonged paralysis after succinylcholine

Surgical Details

Step 6 of 6

Review & Submit

Review patient information before submitting.

Calculated Risk Scores

These scores are auto-calculated based on responses.

RCRI Score
--
Revised Cardiac Risk Index
STOP-BANG
--
Sleep Apnea Risk
DASI / METs
--
Functional Capacity
ASA Class
--
Physical Status

Patient Information Summary

Click any section to expand and review. Click "Edit" to go back and make changes.

Demographics & Basic Information
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Medical History
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Medications & Allergies
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Functional Capacity Assessment
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Airway & Surgical Details
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Consent & Accuracy

Additional Comments (Optional)