The Anesthesia Consultant

NOVEMBER 15, 2023

One day after attending the ASA meeting in San Francisco, I heard an in-person lecture in Palo Alto, California by Professor Anil Patel from the Royal National Throat, Nose and Ear Hospital in London. I believe many smaller hospitals and outpatient facilities such as ambulatory surgery centers do not own the required equipment.

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The Anesthesia Consultant

FEBRUARY 16, 2021

To aid you in visualizing yourself in the hospital, I’m substituting the pronoun “you” instead of “I” in the narrative below. You complete your morning bathroom and breakfast routines, and leave your residence at 0630 hours for the hospital. Your hospital contains multiple operating rooms, and today you are in room #10.

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The Anesthesia Consultant

NOVEMBER 5, 2020

POSTOPERATIVE CARE : Are sleep apnea patients monitored differently in the Post Anesthesia Care Unit? Are OSA patients discharged home after surgery, or are they kept in the hospital? Can apnea patients use their CPAP units during surgery/ in recovery?

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The Anesthesia Consultant

JANUARY 30, 2024

Imagine you’re two months out of anesthesia training, working at a community hospital, and at 2 a.m. you need to induce emergency anesthesia for a 300-pound man who just ate a full meal of pizza and beer two hours earlier. You’re working alone without that anesthesia attending who stood next to you during residency training.

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The Anesthesia Consultant

OCTOBER 11, 2020

A is satisfied that the patient is stable, and the staff prepares to transfer the patient to the post anesthesia care unit (PACU). A hospital bed is stationed to the side of the operating room table, and the monitors are disconnected from the patient. His vital signs remain normal.

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The Anesthesia Consultant

OCTOBER 28, 2018

Dental cases are common, and are frequently referred to a hospital because the typical care systems at an outpatient surgery center or a dental office are inadequate to complete a successful anesthetic. The most common anesthesia induction technique in children and toddlers is an inhalation induction with sevoflurane.

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The Anesthesia Consultant

NOVEMBER 8, 2022

The audit trail is NOT part of the EMR printout, and it’s not visible on the EMR patient care screen that we healthcare providers see. Lawyers can subpoena the audit trail in malpractice legislation, and the hospital must provide the audit trail if the court decides that the audit trail is relevant.

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The Anesthesia Consultant

OCTOBER 18, 2017

You utilize the current multimodal strategies for operating room anesthesia and postoperative pain reduction, including an ultrasound-guided adductor canal block with 0.5% The patient does well, and is discharged from the Post Anesthesia Care Unit in excellent condition. The patient objects. Let’s do it.”

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The Anesthesia Consultant

JANUARY 19, 2017

Some were academic professors, some were trainees at a university, and some were community anesthesiologists either in my group or in other anesthesia companies. We’re entering an era of metrics for physicians, in which the government and hospital systems will collect data to monitor quality and performance.

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The Anesthesia Consultant

MARCH 31, 2015

Kevin Fish of Stanford authored a 1994 book entitled Crisis Management in Anesthesiology , and their work and publications involving teaching via an anesthesia simulator led to the development of cognitive aids for operating rooms in the Palo Alto VA Hospital and also a national VA project. Will you perform perfectly?

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The Anesthesia Consultant

NOVEMBER 28, 2017

Tell the surgeon that the patient needs to have cardiac clearance prior to any general anesthetic, and that the case needs to be done in a hospital setting rather than at a freestanding surgery center. Just do MAC (Monitored Anesthesia Care) anesthesia for this case, but make sure he’s asleep.

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Sullivan Healthcare Consulting

JUNE 4, 2024

Yet, with a single minute in the OR costing as much as $120, ASCs, hospital outpatient departments (HOPD), and ORs regularly waste much more than that. The reasons for low OR utilization rates are multifactorial, yet they often trace back to ineffective pre-anesthesia testing processes. Do it again. Wait another minute. It’s unlikely.

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EARN Cares

OCTOBER 11, 2023

You will want to display any relevant critical care experiences that you have with: Mechanical ventilation, ECG interpretation, caring for patients suffering from strokes, and working with titratable medications. Some hospitals require 1-2 years of ICU or Critical Care experience in order to be hired.

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The Anesthesia Consultant

OCTOBER 14, 2022

Imagine this scenario: You’ve just finished anesthetizing a patient in a hospital setting, and the patient now requires transport from the operating room (OR) to the post-anesthesia care unit (PACU). This is a reasonable policy, but what if anesthesia patient transport to the PACU lasts 4 minutes and 59 seconds (i.e.

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The Anesthesia Consultant

AUGUST 17, 2020

In 1999 the Institute of Medicine published the landmark “To Err is Human” report , which described that adverse events occurred in 3 – 4% of all hospital admissions, and that over 50% of the adverse events were due to preventable medical errors. This hampers care improvement. Mistakes happen in medicine.

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The Anesthesia Consultant

MAY 22, 2018

I stay with the child until the anesthetic depth has dissipated, the breathing tube is removed, and the child is awake and safe with the recovery room nurse in the Post Anesthesia Care Unit. My greatest joy of being a doctor comes immediately after the conclusion of a pediatric anesthetic. Why go to medical school?

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Somnia

MAY 31, 2024

Performance Deficiencies When assessing the anesthesia team’s performance, focus on the quality metrics they use and their approach to achieving efficiency. Transparency is key to monitoring: Slow case turnovers in the OR and Post-Anesthesia Care Unit. Poor alignment with the hospital’s goals and mission.

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The Anesthesia Consultant

MAY 10, 2016

Sugammadex reversal can make the duration of a rocuronium motor block almost as short acting as a succinylcholine motor block, and sugammadex can also eliminate complications in the Post Anesthesia Care Unit due to residual postoperative muscle paralysis. The goal is improved patient care with decreased costs.

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The Anesthesia Consultant

NOVEMBER 15, 2018

The FDA approved the drug to be used in hospital settings only, for the treatment of moderate-to-severe acute pain, where a narcotic is needed and rapid onset is desired, but the route of administration does not require intravenous access. Dsuvia will be marketed as “postoperative, sublingual, patient controlled analgesia.”

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The Anesthesia Consultant

MAY 4, 2016

The surgery and anesthesia proceed uneventfully. The patient is awakened from general anesthesia and taken to the Post Anesthesia Care Unit. She is transferred to a local hospital and admitted to the intensive care unit. The patient accepts these risks. He eventually places the tube successfully.

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The Anesthesia Consultant

MARCH 2, 2018

I tell the patient that after the surgery, in the Post Anesthesia Care Unit, they will be awake and able to make their own decisions whether they desire additional doses of intravenous narcotics or not, with the full knowledge that extra doses of narcotics may bring extra risk of sedation and nausea.

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