The MedStar Health Pre-Anesthesia Team (PAT) plays an important role in our patient’s pre-operative care by reviewing medical history and ensuring all necessary evaluations are completed for a safe and successful anesthesia experience. Our multidisciplinary team conducts comprehensive medical assessments and provides personalized pre-procedure medication instructions to ensure our patients are ready for their procedure and anesthesia.
Before your procedure is scheduled
Before your procedure is scheduled, it is always important to confirm that your contact information is updated with your surgeon’s office at every appointment.
To receive timely updates about your procedure, verify that the cell phone number is listed as the primary contact and that the email address is accurately on file in your chart. The surgeon’s office can assist in providing and updating your contact information.
Once your procedure is scheduled
Once your procedure is scheduled, you will receive secure messages from the MedStar Health Pre-Anesthesia Team via Twistle, our electronic communication platform. These messages will be sent to the patient’s cell phone and/or email address. To access the patient’s personalized questionnaire and instructions, select the secure link and enter the patient’s date of birth for verification. Once the date of birth has been entered, a welcome message will be displayed, providing important information about the next steps in the pre-procedure process with the Pre-Anesthesia team.
It is important that you read and fully complete the PAT Intake Questionnaire via Twistle. Failure to complete the questionnaire may result in delays or cancellation of your procedure.
We understand that some of the information requested in the PAT Intake Questionnaire may already be in your chart. However, to ensure accuracy and compliance, it is important that PAT verifies and updates all patient information. Your cooperation helps us maintain up-to-date records and deliver the best possible care to our patients.
IMPORTANT: The Twistle questionnaire will not route questions to your surgeon’s office. The questionnaire is sent and reviewed by the MedStar Health Pre-Anesthesia Team.
For any questions related to your SURGICAL DATE, TIME, TYPE, DURATION, ADMISSION, or RECOVERY, please contact your surgeon’s office directly.
IMPORTANT: If your health status changes or you visit the hospital or doctor for an illness before their procedure, they must immediately notify the surgeon’s office to provide an update.
After submitting the PAT intake questionnaire
After you submit your PAT Intake Questionnaire via Twistle, our team will review your medical chart, questionnaire, and any pre-procedure test results from your provider(s) to ensure the patient can safely proceed with anesthesia. If our PAT clinician has additional questions, they may contact you via Twistle messaging or phone. Leading up to your surgical date, reminders will be sent via Twistle with important pre-procedure instructions.
Medication Information: Please carefully review this Medication document section. If the PAT clinician determines additional medication instructions are needed, they will contact the patient via Twistle messaging or phone no later than the day before the scheduled procedure.
Pre-operative testing
To assist PAT with gathering pre-operative testing, please have your doctor(s) send their most recent office visit notes and test results to the hospital where your procedure is scheduled. Test results and office visit notes take time to finalize. PAT recommends scheduling appointments early to avoid delays or cancellations.
Cardiology
- If you have an established cardiologist, please ensure they have had an appointment within the last six (6) months of the procedure date.
- If you have any outstanding cardiac testing that has not been completed, you must schedule and complete the testing as soon as possible and before the procedure.
- If you have a pacemaker or a defibrillator (AICD), a device check must be completed within six (6) months of the procedure date. Device check results must be faxed to the hospital where your procedure is scheduled.
- Please ask the cardiology office to fax your latest visit notes, labs, and/or test results to the hospital where your procedure is scheduled. Failure to do so may result in a delay or cancellation of the procedure.
- If you are on a blood thinner(s) and need to stop them for your procedure, please ask the cardiologist to confirm if it is safe and fax the note to the hospital where your procedure is scheduled.
Primary Care
- If the surgeon or PAT determines that you need pre-procedure testing, you may complete the required testing with your primary care doctor/provider before your procedure (e.g., lab work, EKG).
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If you are unable to gain an appointment with your primary care doctor/provider in advance of the procedure date, an appointment can be scheduled online (https://www.medstarhealth.org/services/urgent-care) or by phone (833-394-6977) at any of the MedStar Health Urgent Care locations.
- Please note you will need orders from the surgeon’s office for the pre-procedure testing if completing an appointment at the MedStar Health Urgent Care location.
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- If you have any pre-operative testing performed outside of the MedStar Health system, please ask the office to fax the notes/results to the hospital where your procedure is scheduled.
Other Specialists
- If you have an established Pulmonologist, Hematologist, and/or Endocrinologist and have been seen in the last twelve (12) months, please ensure the office sends the latest visit notes, labs, and/or test results to the hospital where your procedure is scheduled.
Fax numbers
|
Location |
Fax Number |
|---|---|
|
MedStar Franklin Square Medical Center |
443-777-8125 |
|
MedStar Harbor Hospital |
410-354-6859 |
|
MedStar Union Memorial Hospital |
410-469-2901 |
|
MedStar Good Samaritan Hospital |
443-444-4659 |
|
MedStar Montgomery Medical Center |
301-774-8868 |
|
MedStar Georgetown University Hospital |
202-444-4208 |
|
MedStar Washington Hospital Center |
202-877-7063 |
|
MedStar Southern Medical Center |
301-877-4625 |
|
MedStar St. Mary's Hospital |
301-997-6539 |
Pre-procedure medication instructions
To help patients prepare for their procedure, we are providing general medication instructions. If the Pre-Anesthesia team determines the need for more personalized guidance after reviewing the medication list, a clinician will contact the patient via Twistle messaging or phone no later than the day before the scheduled procedure. If the surgeon or prescribing provider gives the patient specific medication instructions, please be sure to follow those carefully.
GLP-1 Agonists (Weekly Injections): STOP for at least EIGHT (8) DAYS before the procedure
- Weekly injections taken for weight loss and/or diabetes, such as semaglutide (Ozempic/Wegovy), tirzepatide (Mounjaro/Zepbound), dulaglutide (Trulicity), liraglutide (Victoza), albiglutide (Eperzan/Tanzeum), or exenatide (Bydureon). Daily injections (Soliqua) or pills (Rybelsus) only need to be stopped on the day of the procedure.
- If the patient is newly prescribed a GLP-1, please wait until after the procedure to begin taking it.
- If the patient takes their weekly injection within seven (7) days of the procedure, their procedure may be canceled.
Over the Counter Medications: STOP seven days (7) before the procedure to avoid increased bleeding or interactions with anesthesia unless instructed otherwise by the surgeon or the prescribing doctor:
- NSAIDs taken for pain: ibuprofen (Advil), naproxen (Aleve/Naprosyn), meloxicam (Mobic), diclofenac (Voltaren), indomethacin (lndocin).
- All over-the-counter vitamins (including vitamin E) and/or any herbal supplements.
- This includes but is not limited to ginseng, ginkgo, turmeric, garlic, and echinacea.
Prescribed Vitamins or Supplements
- If sodium or potassium pills are prescribed by the patient’s doctor and filled by the pharmacy, these are considered prescription medications. The patient can continue taking them as prescribed by their doctor.
Aspirin: Not all procedures require patients to stop Aspirin
- Patients who have a history of a heart stent, stroke, or vascular surgery should obtain permission to stop Aspirin from their prescribing doctor if the surgeon requests the patient to stop it.
- Patients taking Aspirin for pain or prevention only should follow instructions given by their surgeon. Please contact the surgeon’s office directly with any questions regarding Aspirin.
- Note: Over-the-counter products that contain Aspirin include BC Powder and Alka-Seltzer.
- When needed for certain procedures, Aspirin is typically held for five (5) – seven (7) days.
Phentermine: STOP for at least FIVE (5) DAYS before the procedure
- Phentermine must be stopped at least five (5) days before the procedure.
SGLT-2 Inhibitors: STOP THREE (3) DAYS before the procedure
- SGLT-2 inhibitors (alone and in combination pills) such as canagliflozin (Invokana, lnvokamet), dapagliflozin (Farxiga, Xigduo, Qtern), empagliflozin (Jardiance, Synjardy, Glyxambi, Trijardy XR).
- Ertugliflozin (Steglatro, Segluromet, Steglujan) should be stopped for four (4) days before the procedure
- If the patient has diabetes, they should check their blood sugar twice a day and call their prescribing doctor if their blood sugar is higher than 250.
Blood Thinners: Stop ONLY if your surgeon requests. These include warfarin (Coumadin), enoxaparin (Lovenox), apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), clopidogrel (Plavix), ticagrelor (Brilinta), prasugrel (Effient), or cilostazol (Pletal).
- If prescribed by cardiology/vascular/hematology/primary care doctor, the patient will need to consult with their doctor to ensure it is safe to stop. These are usually stopped no longer than one (1) – seven (7) days depending on the medication(s).
If the surgeon or prescribing doctor gives additional medication instructions, please follow those instructions closely.
Pre-procedure food and drink instructions (NPO)
Before your procedure, please do not eat solid foods after midnight before your scheduled procedure time. This includes milk, cream, and gelatin.
In accordance with best practice, the MedStar Health anesthesia team encourages patients to:
- Drink up to twelve (12) ounces of water or an electrolyte/sports drink (e.g., Gatorade, Powerade, or Pedialyte), ensuring it is finished at least four (4) hours before the patient’s scheduled procedure time.
- Acceptable alternatives are black coffee, tea, or apple/cranberry juice.
- Please avoid soup, broth, dairy, or pulp-containing juices, such as orange or grapefruit juice.
- If the patient has diabetes, please hydrate with water instead of a sugary drink so their blood sugar does not become too elevated, as this may result in a cancellation of the procedure.
- If the patient is having a colonoscopy, please avoid any fluids with red dye or coloring.
Other PAT resources
Hospital-based services and information
For hospital-specific services and questions, please visit their websites for additional information: