STEP 1:
Surgical Risk Category ECG
CBC or Hct
(no diff)
Ferritin /
TIBC / Iron
BMP CMP Cr PT/INR PTT
Provider
Notes
I (low risk)
II (intermediate risk)
III (higher risk)
CBC within
180 d
IV (highest risk)
CBC within
180 d
180 d
SURGICAL
RISK
Providers:
Consider type and
screen for
anticipated EBL >
500 ml
PREADMIT TESTING GRID
For Cariovascular OR cases, Transcatheter Aortic Valve Replacement (TAVR) and Laser Lead Extraction cases,
skip Steps 1 and 2 and proceed directly to "Heart Institute Cases" section at the end of this document.
For all Main OR cases, proceed to Step 1.
For MRSA / MSSA Swab guidance, please refer to the surgical decolonization policy in PolicyStat (click this link).
Determine surgical risk by identifying the procedure on the surgical risk grid that most closely matches the patient's scheduled procedure
COVID-19 PCR
Required 3 days prior to
surgery (Surgery is day zero)
Required 3 days prior to
surgery (Surgery is day zero)
