Anesthesia Outside OR and Patient Safety

Abstract

The number of procedures performed outside of the operating room continues to expand tremendously. The need for cost containment, along with rapid technological advancement and an increasing population of ageing and medically involved patients, has increased the demand for minimally invasive surgical alternatives and complex diagnostic and therapeutic procedures. These are now commonly performed in non–operating room areas of the hospital and physicians’ offices. As a result, anesthesiologists are now frequently requested to provide services outside of the traditional operating room environment. In the light of such a significant expansion in the venue of anesthesiology practice, there is an urgent need for a preoperative patient evaluation, perioperative monitoring, anesthetic techniques for quality assurance. The overall goal is to clarify and to reframe our standards of safety and medical practice so that they are appropriate for anesthetizing locations that are outside of the main OR. Hundreds of thousands of procedures performed in remote locations, putting the anesthesia provider into an unfamiliar environment with limited resources. Many intervensions develop the anesthesia outside the operating room such as: Radiology suites, interventional radiology, magnetic resonance imaging, Computed tomography, Ultrasound, Cardiac catheterization and electrophysiology, Endoscopy suite Emergency room, Out patient (dentists) Critical care units. When providing care at such locations, anesthesiologists must maintain the same high standard of anesthetic care provided in the operating suit. The anesthetizing location must be surveyed by the anesthesiologist to determine whether anesthetic care can be delivered safely in that location before delivery of that care.