Anterior Hip
Anterior Hip
Anterior Hip
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13. AnesthesiaHave you ever had anesthesia?If yes, do you have difficulty waking up after the anesthetic?Have you or any family member been told you had a high feverwith general anesthesia?Have you ever been told that the anesthesiologist had a difficulttime putting a tube in for breathing during surgery?Do you have problems with nausea or vomiting afterreceiving anesthesia?apple Yes apple Noapple Yes apple Noapple Yes apple Noapple Yes apple Noapple Yes apple NoPlease check any of the following conditions, illnesses or problems you have now or have had:___ TB ___Rheumatic Fever ___Cancer (Where:_____)___Scarlet Fever ___Polio ___Tumor (Where:_____)___Hives/Rashes ___Psoriasis ___Bronchitits___Diverticulitis ___Hemorrhoids ___High Blood Pressure___Lung disease ___Pneumonia ___Heart Attack (When:____)___Heart Trouble ___Blood Transfusion ___Hernia (Type:___)___Pancreatitis ___Gall Bladder Trouble ___Yellow Jaundice___Malaria ___Anemia ___Blood Clots/Phlebitis___Stroke ___Ulcers (Where:___) ___Drug /Substance Abuse___Psychiatric disorder___Reactions to anesthesiaOther information you would like us to know: