Recent Updates in Safety Guidelines during Anaesthesia in Remote Areas
Tarek Ahmed Abdel-Ghany Wahba;
Abstract
Summary
A
naesthesiainremotelocationsreferstoadministrationofsedationoranaesthesiaoutsidetheoperatingroomtopatientsundergoingpainfuloruncomfortableprocedures.Duetotechnologicaldevelopmentsinmedicalequipment,theseproceduresareincreasing.
Generallytheroleoftheanaesthesiologististorelievethepainandanxiety,ensuresafetyandkeepthepatientimmobileinsomecasessuchasMRI.
Examplesforanaesthesiainremotelocationsincluderadiologyunits,endoscopyunit,cardiaccatheterizationlaboratory,ESWL.Therefore,cooperationwithmanydifferentspecialistsinvariouslocationsisrequired.
Toprovidesafeandqualifiedanaestheticcareoutsideoperatingroom,itisimportantfortheanaesthesiologiststoconstructasystemic,uniformstructureappliedequallythroughoutthehospital,notonlytoensurethepatient'ssafetybutalsotoguaranteethesafetyofhealth-careproviders.
BasicmonitoringforanaesthesiainremotelocationsdoesnotdifferfromanaestheticmonitoringintheoperatingroomwhichincludesNIBP,pulseoximetry,ECGandcapnography.
Othernon-standardmonitoringmaybeneededaccordingtotheprocedureorthemedicalsituationofthepatient.
ProvidinganaestheiaoutsidetheORshouldbedoneinwell-equippedplacejustatthesamelevelofthemaintheaterwiththesamesuppliesandfacilitiesespeciallytheemergencyones.
AseverysingleprocedureoutsidetheORhasitsownanaestheticconsiderationgoodpre-operativeassessmentintheformofdetailedhistory,examinationandinvestigation(accordingtotheprocedureandthepatientmedicalcondition)isanimportantsteptoensurethepatientsafetye.g.excludinganyrenalinsufficiencybeforecontrastmediaadministrationinMRIismandatory.
IntheradiologyunitoneofthedangerouschallengesisthereactionfromtheIVcontrast,sosafetyguidelinesshouldbeappliedtopreventmorbiditiesandmortalities.
TheferromagneticfieldoftheMRIshowsmanyhazardsontheanaestheticequipmentandalsotheanaestheticequipmentmayaffectthemagneticfieldcreatingimageartifacts.
Anaestheticgoalsfortheinterventionalneuroradiologyproceduresaremaintainingneuromuscularrelaxationforgoodimagequality,rapidandsmoothrecoveryforimmediatepost-proceduralneurologicexamination,maintaininganti-coagulation,managingsuddencomplicationsandprotection against radiationhazards.
Thepediatricagegroupisconsideredachallengeinanyremotelocationasitrequiresespecialequipmentandespecialanaestheticmanagement.
Post-operativeorpost-sedationcaresimilartothataftergeneralanaesthesiamustbeprovidedinastandardizedmanner.Preventableadverserespiratoryeventsoccurduringtherecoveryorpostoperativeperiods,sostrictsurveillanceisnecessaryuntilfullrecovery.Apost-anaestheticorpost-sedationscoremustbegivenunlessthepatientistakendirectlytoanintensivecareunit,whereintensivemonitoringwillcontinue.
A
naesthesiainremotelocationsreferstoadministrationofsedationoranaesthesiaoutsidetheoperatingroomtopatientsundergoingpainfuloruncomfortableprocedures.Duetotechnologicaldevelopmentsinmedicalequipment,theseproceduresareincreasing.
Generallytheroleoftheanaesthesiologististorelievethepainandanxiety,ensuresafetyandkeepthepatientimmobileinsomecasessuchasMRI.
Examplesforanaesthesiainremotelocationsincluderadiologyunits,endoscopyunit,cardiaccatheterizationlaboratory,ESWL.Therefore,cooperationwithmanydifferentspecialistsinvariouslocationsisrequired.
Toprovidesafeandqualifiedanaestheticcareoutsideoperatingroom,itisimportantfortheanaesthesiologiststoconstructasystemic,uniformstructureappliedequallythroughoutthehospital,notonlytoensurethepatient'ssafetybutalsotoguaranteethesafetyofhealth-careproviders.
BasicmonitoringforanaesthesiainremotelocationsdoesnotdifferfromanaestheticmonitoringintheoperatingroomwhichincludesNIBP,pulseoximetry,ECGandcapnography.
Othernon-standardmonitoringmaybeneededaccordingtotheprocedureorthemedicalsituationofthepatient.
ProvidinganaestheiaoutsidetheORshouldbedoneinwell-equippedplacejustatthesamelevelofthemaintheaterwiththesamesuppliesandfacilitiesespeciallytheemergencyones.
AseverysingleprocedureoutsidetheORhasitsownanaestheticconsiderationgoodpre-operativeassessmentintheformofdetailedhistory,examinationandinvestigation(accordingtotheprocedureandthepatientmedicalcondition)isanimportantsteptoensurethepatientsafetye.g.excludinganyrenalinsufficiencybeforecontrastmediaadministrationinMRIismandatory.
IntheradiologyunitoneofthedangerouschallengesisthereactionfromtheIVcontrast,sosafetyguidelinesshouldbeappliedtopreventmorbiditiesandmortalities.
TheferromagneticfieldoftheMRIshowsmanyhazardsontheanaestheticequipmentandalsotheanaestheticequipmentmayaffectthemagneticfieldcreatingimageartifacts.
Anaestheticgoalsfortheinterventionalneuroradiologyproceduresaremaintainingneuromuscularrelaxationforgoodimagequality,rapidandsmoothrecoveryforimmediatepost-proceduralneurologicexamination,maintaininganti-coagulation,managingsuddencomplicationsandprotection against radiationhazards.
Thepediatricagegroupisconsideredachallengeinanyremotelocationasitrequiresespecialequipmentandespecialanaestheticmanagement.
Post-operativeorpost-sedationcaresimilartothataftergeneralanaesthesiamustbeprovidedinastandardizedmanner.Preventableadverserespiratoryeventsoccurduringtherecoveryorpostoperativeperiods,sostrictsurveillanceisnecessaryuntilfullrecovery.Apost-anaestheticorpost-sedationscoremustbegivenunlessthepatientistakendirectlytoanintensivecareunit,whereintensivemonitoringwillcontinue.
Other data
| Title | Recent Updates in Safety Guidelines during Anaesthesia in Remote Areas | Other Titles | أحدث التطورات فى إرشادات السلامة أثناء التخديرخارج نطاق غرفة العمليات | Authors | Tarek Ahmed Abdel-Ghany Wahba | Issue Date | 2016 |
Attached Files
| File | Size | Format | |
|---|---|---|---|
| G13134.pdf | 313.06 kB | Adobe PDF | View/Open |
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