Outpatient Surgery Magazine

Is Your Data Secure? Subscribe to Outpatient Surgery Magazine - November 2017

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 2 7 Who's Unsafe for Outpatient Surgery? Certain patients shouldn't get past your anesthesia gatekeepers. A s more and more com- plex proce- dures find their way into outpatient facili- ties, it's crucial for your anesthesia providers to deter- mine which patients are appropriate for same-day surgery — and which are not. But how do they do it? As you'll see, there's no foolproof way to determine who's a good candidate for outpatient surgery. Most of us are familiar with the ASA scores, but they really don't measure operative risk (see "ASA Scores Don't Measure Operative Risk" on page 20). Keep in mind that all outpatient facilities are not created equal. A patient who may not be a candidate for office-based surgery may be fine in a surgery center. And a patient who may not be a candidate for a freestanding ASC may be fine in a hospital-based outpatient center. Here are some red flags and considerations when it comes to patient selection: • Age (But physiologic age is more important than chronological age.) • Abnormalities of major organ systems • Expected difficult airways, based on Mallampati score, recessed chin, major overbite, small mouth or large tongue Anesthesia Alert Perry V. Ruspantine, CRNA, APRN • SIGNS OF TROUBLE Several factors suggest potential difficult airways, which should be a red flag for any freestanding surgery center. Pamela Bevelhymer, RN, BSN, CNOR

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