Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/309684
6 4 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M AY 2 0 1 4 3. Careful recoveries Patients receive 2 to 3 liters of crystalloid IV fluids in recovery. They qualify for same-day discharge if they're able to ambulate after sur- gery, have normal room-air saturation, are PONV-free and can tolerate liquids. Patients discharged the day of surgery have IV cannulas placed and receive saline locks. They return the next morning for assessment and 1 to 2 more liters of crystalloid fluid therapy. We have a transfer agreement with a community hospital near the surgery center. We currently require mandatory sleep apnea assess- ment for patients who register scores higher than 2 on the STOP- BANG assessment tool. (Before the review of our first 250 cases, the assessment was recommended, but not mandatory.) They must also document compliance with CPAP therapy and be cleared for surgery by their sleep-care providers. We now observe all patients with sleep apnea or suspected sleep apnea cleared for surgery overnight in the surgery center. Proceed with caution LSG performed in a surgery center requires consistent staffing (which has been shown to enhance patient care and improve outcomes), prop- er bariatric equipment, scheduling and protocols. All those factors lead to safer and more efficient surgeries than what's possible in inpatient ORs. Although LSG in the outpatient arena is far from novel, very little data supports its safety in a freestanding ASC. Surgeons who want patients to remain hospitalized overnight fol- lowing surgery are understandably concerned that several factors could jeopardize same-day discharges: nausea and vomiting, post-op pain, dehydration and a lack of monitoring to detect early-stage com- plications once patients are recovering at home. But we've shown that careful patient selection and extensive pre-op screenings identify B A R I A T R I C S U R G E R Y © 2014 Olympus America Inc. Trademark or Registered Trademark of Olympus or its affiliate entities in the U.S. and/or other countries of the world. All patents apply. OAIENE0613AD11270 The World's ONLY Articulating HD 3D Video System The World's ONLY Universal Platforms Deliver Innovative, Cost-Effective Solutions Fully-Integrated Ultrasonic and Advanced Bipolar Technology For More Information contact your local Olympus representative at 800.848.9024 or visit www.medical.olympusamerica.com OSE_1405_part2_Layout 1 5/8/14 2:23 PM Page 64