Faculty Opinions recommendation of Interactions between anesthesiologists and the environment while providing anesthesia care in the operating room.

2013 ◽  
Author(s):  
Yoshinori Nakata
Keyword(s):  
Operating Room ◽  
Anesthesia Care

Pediatric Anesthesia Outside of the Operating Room

2011 ◽  
pp. 236-243
Author(s):  
Keira P. Mason
Keyword(s):  
Operating Room ◽  
Patient Management ◽  
Pediatric Anesthesia ◽  
Anesthesia Care ◽  
Life Threatening

The anesthesiologist is increasingly being called on to provide pediatric anesthesia care for children in settings outside the operating room (OR). Providing anesthesia in these off-site venues challenges us to gain a familiarity with the procedures, tailor an anesthesia plan to the procedure and location, as well as to plan for the management of life-threatening situations. This chapter will review the different off-site locations and discuss the unique aspects of patient management associated with each area. Typical locations are outlined in Table 24.3.

scholarly journals A quantitative study on personnel’s experiences with patient handovers between the operating room and the postoperative anesthesia care unit before and after the implementation of a structured communication tool

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ann-Chatrin Leonardsen ◽  
Ellen Klavestad Moen ◽  
Gro Karlsøen ◽  
Trine Hovland
Keyword(s):  
Operating Room ◽  
Time Pressure ◽  
Statistical Significance ◽  
Linear Regression Analysis ◽  
Relevant Information ◽  
Logical Structure ◽  
Anesthesia Care ◽  
Communication Tool ◽  
Before And After ◽  
Patient Handovers

Postoperative handover of patients has been described as a complex work process challenged by interruptions, time pressure and a lack of supporting framework. The purpose of this study was to investigate involved personnel’s experiences with the quality of patient handovers between the operating room and the postoperative anesthesia care unit (PACU) before and after implementation of a structured tool for communication. The study was conducted in a hospital in South-eastern Norway. Personnel completed a questionnaire before (n=116) and after (n=90) implementation of the Identification-Situation-Assessment- Recommendations (ISBAR)- tool. Analysis included summative statistics, t-tests and generalized linear regression analysis. Statistical significance assumed at P<0.05. The overall impression of quality in handovers improved significantly after implementation of the ISBAR (P=0.001). Personnel’s experiences were improved in relation to that handovers followed a logical structure, available documentation was used and all relevant information was communicated (P<0.001). Moreover, personnel found it easier to establish contact at the beginning of the handover, ambiguities were resolved and documentation was more complete (P=0.001). Profession was associated with seven of the statements, relating to whether relevant information is clearly communicated, whether possible risks and complications are discussed, contact easily established, and to completeness of documentation and information. In addition, findings indicate significantly more negative experiences among receiving personnel both pre- and post-implementation. Implementation of a structured tool for communication in patient handovers, may improve quality and safety in patient handovers between the operating room and the PACU. Research is needed to define optimal patient handovers and to determine the effect of handover quality on patient outcomes.

Reengineering Intravenous Drug and Fluid Administration Processes in the Operating Room

2002 ◽  
Vol 97 (1) ◽  
pp. 139-147 ◽  
Author(s):  
Deborah B. Fraind ◽  
Jason M. Slagle ◽  
Victor A. Tubbesing ◽  
Samuel A. Hughes ◽  
Matthew B. Weinger
Keyword(s):  
Operating Room ◽  
De Novo ◽  
Significant Proportion ◽  
Cost Of Care ◽  
Fluid Administration ◽  
Intravenous Drug ◽  
Anesthesia Care ◽  
Drug Preparation ◽  
Anesthesia Providers ◽  
Set Up

Background A reengineering approach to intravenous drug and fluid administration processes could improve anesthesia care. In this initial study, current intravenous administration tasks were examined to identify opportunities for improved design. Methods After institutional review board approval was obtained, an observer sat in the operating room and categorized, in real time, anesthesia providers' activities during 35 cases ( approximately 90 h) into 66 task categories focused on drug/fluid tasks. Both initial room set-up at the beginning of a typical workday and cardiac and noncardiac general anesthesia cases were studied. User errors and inefficiencies were noted. The time required to prepare de novo a syringe containing a mock emergency drug was measured using a standard protocol. Results Drug/fluid tasks consumed almost 50 and 75%, respectively, of the set-up time for noncardiac and cardiac cases. In 8 cardiac anesthetics, drug/fluid tasks comprised 27 +/- 6% (mean +/- SD) of all prebypass clinical activities. During 20 noncardiac cases, drug/fluid tasks comprised 20 +/- 8% of induction and 15 +/- 7% of maintenance. Drug preparation far outweighed drug administration tasks. Inefficient or error prone tasks were observed during drug/fluid preparation (e.g., supply acquisition, waste disposal, syringe labeling), administration (infusion device failure, leaking stopcock), and organization (workspace organization and navigation, untangling of intravenous lines). Anesthesia providers (n = 21) required 35 +/- 5 s to prepare a mock emergency drug. Conclusions Intravenous drug and fluid administration tasks account for a significant proportion of anesthesia care, especially in complex cases. Current processes are inefficient and may predispose to medical error. There appears to be substantial opportunity to improve quality and cost of care through the reengineering of anesthesia intravenous drug and fluid administration processes. General design requirements are proposed.

scholarly journals Post-anesthesia care unit desaturation in adult deep extubation patients

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Jeremy Juang ◽  
Martha Cordoba ◽  
Mark Xiao ◽  
Alex Ciaramella ◽  
Jeremy Goldfarb ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Operating Room ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Safe Option ◽  
Recovery Times ◽  
History Of ◽  
Endotracheal Extubation

Abstract Objective Deep extubation refers to endotracheal extubation performed while a patient is deeply anesthetized and without airway reflexes. After deep extubation, patients are sent to the post-anesthesia care unit (PACU) to recover, an area with notably different management and staffing than the operating room (OR). One of the most frequent and concerning complications to occur in the PACU is hypoxemia. As such, this study seeks to evaluate the incidence of desaturation, defined by SpO2 < 90% for longer than 10 s, in the PACU following deep extubation. Additionally, we hope to assess the consequence of desaturation on perioperative workflow by comparing PACU recovery times. Results Following deep extubation, 4.3% of patients (13/300) experienced desaturation in the PACU. Every episode was notably minor, with patients reverting to normal saturation levels within a minute. Of the 26 case factors assessed, 24 had no significant association desaturation in the PACU, including the amount of time spent in the PACU. History of asthma was the only statistically significant factor found to be positively associated with desaturation. We find that PACU desaturation episodes following deep extubation are rare. Our findings suggest that deep extubation is a viable and safe option for patients without significant respiratory tract pathology.

Pediatric Anesthesia Outside of the Operating Room

2018 ◽  
Author(s):  
Mohamed Mahmoud ◽  
Robert S. Holzman ◽  
Keira P. Mason
Keyword(s):  
Emergency Department ◽  
Operating Room ◽  
Electroconvulsive Therapy ◽  
Practice Guidelines ◽  
Current Practice ◽  
Pediatric Anesthesia ◽  
Infertility Treatment ◽  
Anesthesia Care ◽  
Dental Procedures ◽  
Practical Recommendations

This textbook provides an important tool to cover major aspects of anesthesia care in non–operating room anesthesia (NORA) locations. It outlines perioperative concerns for the most commonly performed procedures in NORA settings. An overview of various anesthesia delivery techniques and tools required to optimize the patient before endoscopy, cardiac, and neuroradiology procedures are provided. The text also covers specialized situations, including a pediatric update on anesthesia/sedation strategies for dental procedures, electroconvulsive therapy, cosmetic procedures, ophthalmologic surgery, procedures in the emergency department, and infertility treatment. Practical recommendations based on current literature and author experience are presented, and current practice guidelines are reviewed.

Anesthesia Care on the Day of Surgery

2018 ◽  
Author(s):  
Claudia F. Clavijo ◽  
Mary E. Arthur ◽  
Efrain Riveros-Perez
Keyword(s):  
Operating Room ◽  
Patient Monitoring ◽  
Patient Positioning ◽  
Anesthesia Care ◽  
Sequence Of Events ◽  
Anesthesia Residents ◽  
At Home

This chapter provides anesthesia residents with recommendations that will guide them through the sequence of events on the day of surgery. This chapter focuses on operating room setup, basic pharmacology, medications typically used in the operating room, guidelines for discontinuation of at-home medications, intraoperative patient monitoring, and ventilation. There is also a detailed discussion on patient positioning and potential complications related to positioning. Checklists facilitate efficiency and ensure that all important steps are completed before patients receive anesthesia care. These recommendations may be adjusted to meet specific needs and institutional standards.

Anesthesia Outside of the Operating Room

2011 ◽  
Author(s):  
Richard Urman ◽  
Wendy Gross ◽  
Beverly Philip
Keyword(s):  
Quality Assurance ◽  
Patient Care ◽  
Operating Room ◽  
Patient Monitoring ◽  
Patient Care Team ◽  
Anesthetic Techniques ◽  
Anesthesia Care ◽  
Post Procedure ◽  
Anesthesia Providers ◽  
Physical Resources

This is a comprehensive, up-to-date resource that covers all aspects of anesthesia care in OOR settings, from financial considerations to anesthetic techniques to quality assurance. With increasing numbers of procedures such as cardiac catheterization and imaging taking place outside of the main OR, anesthesia providers as well as non-anesthesia members of the patient care team will find this resource critical to their understanding of the principles of anesthesia care in unique settings which may have limited physical resources. Topics include patient monitoring techniques, pre-procedure evaluation and post-procedure care, and procedural sedation performed by non-anesthesia providers.

Anesthesia and Sedation Outside of the Operating Room: Outcomes, Regulation, and Quality Improvement

2011 ◽  
pp. 62-73
Author(s):  
Julia Metzner ◽  
Karen B. Domino
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Operating Room ◽  
Continuous Quality Improvement ◽  
Improve Patient Safety ◽  
Anesthesia Care ◽  
Remote Locations ◽  
Continuous Quality ◽  
National Patient ◽  
Improve Patient

Providing anesthesia care in areas outside the operating room (OOOR) has numerous challenges, including an unfamiliar environment; inadequate anesthesia support; deficient resources; cramped, dark, small rooms; and variability of monitoring modalities. In addition, sicker patients are undergoing more complex procedures in areas that may be physically located far from the OR environment. To improve safety of patients undergoing procedures in remote locations, practitioners need to be familiar with development of rigorous continuous quality improvement systems, national and regulatory patient safety efforts, as well as complications related to anesthesia/sedation in OOOR settings. This chapter will identify severe outcomes and mechanisms of injury in these remote locations, national patient safety and regulatory efforts that may be adapted to the OOOR setting, and quality improvement efforts essential to track outcomes and improve patient safety.

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