Protocols

	< 65 years or ASA I (normal healthy patient)	> 65 years or ASA ³ II (at least with mild systemic disease)
Low risk Surgery Endoscopy Eye surgery	None	None Additional tests to be conducted based on the decision of the anesthesiologist (CBC-Platelets, Creatinine, INR, PTT, Electrolytes, etc..)
Other Low risk Surgery	None	CBC-Platelets, Creatinine Additional tests to be conducted based on the decision of the anesthesiologist (INR, PTT, Electrolytes, etc..)
Intermediate and high-risk surgery	CBC-Platelets, Creatinine Additional tests to be conducted based on the decision of the anesthesiologist (INR, PTT, Electrolytes, Type and screen, ECG, etc..)	CBC-Platelets, INR, PTT Creatinine, Electrolytes ECG

	Indicated	Not indicated
ECG	Minor surgery in patient with severe coronary artery disease High and intermediate risk surgery	Minor surgery in asymptomatic patients ECG done in <1 year without clinical changes
Chest X-Ray	Patient with cardiac and pulmonary history Patient with acute or evolutive pulmonary history	Patient undergoing non-cardiothoracic surgery regardless of age

Surgical Risk Estimate According to Type of Surgery
Low risk surgery

Ambulatory surgery
Superficial surgery
Eye surgery
Breast surgery
Dental surgery

Minor gynecology
Minor orthopedic surgery (Arthroscopy…)
Endocrine: thyroid surgery
Endoscopic procedures

Intermediate and high-risk surgery

Orthopedic surgery	Abdominal surgery	Urology -gynecology	Neurosurgery
Total hip replacement Total knee replacement Total shoulder replacement Spine surgery Other major orthopedic surgeries	Colectomy Esophagectomy Gastrectomy Hiatal hernia Whipple Hepatic surgery Cholecystectomy Splenectomy Adrenal resection Repair of perforated bowels	Major Urological and gynecological surgeries Cystectomy Radical prostatectomy Nephrectomy Renal transplant TURP/TURB	Craniotomy Medullary tumor

ENT	Vascular surgery	Cardiothoracic surgery
Head and neck surgery Vascular pathology (angioma) Amygdalotomy	Carotid endarterectomy Endovascular aortic aneurysm repair Peripheral arterial angioplasty Aortic and major vascular resection Open lower revascularization for acute limb ischemia or amputation	Cardiac surgery Pulmonary surgery Mediastinal surgery

American Society Anesthesiologists (ASA) classification
ASA I: Normal Healthy individual.
ASA II: Patient with mild systemic disease.
ASA III: Patient with severe systemic disease.
ASA IV: Patient with severe systemic disease that is a constant threat to life.
ASA V: Moribund patient who is not expected to survive without the operation.
ASA VI: declared brain dead patient whose organs are being removed for donor purposes.