A Simplified Decision Algorithm to Proceed with an Elective Procedure in Patients with a History of Cocaine and Methamphetamine Use-Presentation Slides

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The document presents a simplified decision algorithm for proceeding with elective procedures in patients with a history of cocaine and methamphetamine use. It outlines the physiological changes and perioperative risks associated with drug use, as well as the importance of risk stratification and urine drug screening before procedures. The algorithm aims to guide anesthesia professionals in making informed clinical decisions for such patients.<br /><br />The research explores the safety of administering anesthesia to patients with a history of drug use compared to those who do not use drugs. It emphasizes the need for comprehensive patient evaluation, risk assessment tools, and the limited utility of routine urine drug screens in precluding patients from procedures. The document includes a literature review on the effects of cocaine and methamphetamine, potential cardiac risks, and outcomes of drug-positive patients undergoing surgery.<br /><br />Clinical scenarios of two patients, Keith and Sarah, are presented to demonstrate the application of the algorithm. Recommendations include delaying procedures for high-risk patients like Keith until drug screens are negative and counseling patients on substance use cessation. The discussion highlights the algorithm's strengths in reducing practice variation and improving access to care for individuals with substance use disorders.<br /><br />In conclusion, the algorithm provides a valuable tool for managing patients with a history of drug use undergoing elective procedures, emphasizing the importance of comprehensive assessment and individualized decision-making. Future research aims to validate the algorithm and enhance risk assessment strategies in this patient population.

Keywords

decision algorithm

elective procedures

cocaine use

methamphetamine use

perioperative risks

urine drug screening

anesthesia

risk stratification

substance use disorders

patient evaluation