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Canadian Journal of Anesthesia, Vol 12, 311-313, Copyright © 1965 by Canadian Anesthesiologists' Society

Pre-Anaesthetic Patient Questionnaire

P A CHARLEBOIS BA, BSC, MD1

1 Department of Anaesthesia, Scarborough General Hospital, Scarborough, Ont., and Scarborough Medical Research Foundation

A simple basic patient questionnaire is presented, on which the preoperative patient may record a number of factors relating to his, medical history which are of importance to the anaesthetist. It has been found to be of value to the Department of Anaesthesia in making preoperative rounds, and to the nurses and attending surgeons. It quickly presents positive information about the individual patient, and may be used for statistical purposes.






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Copyright © 1965 by the Canadian Anesthesiologists' Society.