Preop Eval vs Opioids Dosage Conversion

Preop Eval organizes and presents much of the guidance that one needs in order to evaluate and prepare adult patients for non-cardiac surgery. It is based upon the guidelines on this topic from the American College of Cardiology, the European Society of Anaesthesiology, the American Society of Anesthesiologists, the Institute for Clinical Systems Improvement, the American College of Chest Physicians, and more (full references in the app). The app contains 1 algorithm and 3 resources: the cardiac evaluation algorithm, guidance on starting and stopping key medications in the perioperative period, guidance on timing of surgery after cardiac events, and guidance on preoperative testing. It also contains a review of preoperative evaluation mainly for students and residents. The app addresses such common questions as: - who needs bloodwork before surgery? - who needs an EKG or a CXR? - how do I handle patients on warfarin, clopidogrel, and DOAC's? - which patients need adjustment of perioperative insulin and diabetic meds, and how? - which active cardiac conditions preclude surgery? - how long after MI or stent should a patient wait before surgery? - are there adjustments to make on psych meds, rheumatologic meds, ACE's and ARB's? This app is written and intended for practicing physicians like internists, family physicians, and hospitalists; for resident physician trainees; and for medical students. In addition to being a reference, the algorithm is written to be a teaching tool by not just delivering an answer, but instead walking a physician through the evaluation process so that one learns that process along the way. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.

Opioids by Chris Marcellino MD and Norris Vivatrat MD is an opioid analgesic dosage conversion calculator for use by trained medical professionals. The application supports conversion to and from opioids commonly prescribed and used in U.S. hospitals orally, parenterally, or transdermally, including morphine, codeine, hydromorphone, hydrocodone, fentanyl, methadone, oxycodone and oxymorphone. The application is intended to help and instruct in the process of conversion of opioid regimens. • Native support for iPhone, iPad and iPod touch • Multiple route support • Multiple drug support • Incomplete cross tolerance option • Breakthrough dosing calculator • Provides instructional details about each calculation • Saves last calculation on exit • Supports landscape and portrait modes • Reference guide By Professor EBM, the Internal Medicine Residency Teaching Resource for Evidence-Based Medicine: http://www.professorebm.com/, a resource of the Santa Clara Valley Medical Center. While effort has been made to ensure that calculations are accurate and that conversion factors are in accordance with current accepted medical practices, use of this application is entirely at your own risk. This application should only be used by trained medical professionals and all results should be double checked by hand. Use of the app requires acceptance of the terms of use that are included with the application. Please send support requests and feedback using the link in the About tab of the app, though as a free academic tool we only have limited resources to address new feature requests. Opioid equipotency data is taken from CAPC conversion values except where noted (see the reference tab in the app.) CAPC values are as published in the Center to Advance Palliative Care Prescribing Opioids: A Reference Guide curriculum, which are adapted from McPherson ML. Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing, 2nd ed. American Society of Health-System Pharmacists, Bethesda, Maryland, 2018. EPEC values are as published in EPEC-O Participants Handbook, 2005. Chris Marcellino, MD — Mayo Clinic Norris Vivatrat, MD — UCSD Medical Center Special thanks to Dr. Tom Mouser (EveryStep, Des Moines, IA) and Dr. David Rand (UVM Medical Center).