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J A N U A R Y 2 0 1 5 | 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
At Rappahannock General Hospital in Kilmarnock, Va., they don't
usually start an IV on a local procedure unless an antibiotic is
ordered, says Perioperative Director Karen Fariss, RN. They place all
local patients on a cardiac monitor and an RN dedicated to monitor-
ing the patient monitors rate, rhythm, NIBP, respiration and SpO
2
every 5 to 15 minutes, adds Ms. Fariss. "We do not routinely call anes-
thesia into a local case because that would be asking them to assume
responsibility for a patient that they have not worked up," she adds.
A manager at a facility that does solely local cases doesn't start IVs
or require patients to fast. "The circulator monitors vitals and oxygen
saturation every 15 minutes during the procedure and in recovery for
20 to 30 minutes or until vitals are stable," she says.
"No IV unless antibiotics are needed. Always have a nurse dedicated
to monitoring the patient. Most of our locals are in the afternoon at the
end of a general line so we allow patients to eat a light breakfast but
otherwise follow ASA NPO guidelines," says Andy Beck, RN, BSN,
CAPA, director of surgical services at Providence Surgery Center in
Missoula, Mont.
One facility says it uses saline locks on everyone. "We've had too
many cases where anesthesia is called for and we have no IV access,"
says the administrator. "It's also a patient safety guideline for us."
— Dan O'Connor
