diopulmonary history, a sur-
gery to remove a renal mass
in 2001 and severe
osteoarthritis. His past surgi-
cal history included several
lumbar disc surgeries and a
cervical fusion performed
within the past few years. At
5-foot-9 and 150 pounds, he
certainly wasn't overweight.
But the airway evaluation
a week before his procedure
date set off the alarms. The
surgery center does all of its
shoulder cases under an
interscalene block, but Dr.
Jacobs was concerned
about a difficult intubation
should the need arise. "He
had minimal-to-no neck
extension," says Dr. Jacobs, "so we opted to have his procedure done
at the hospital."
At first, the patient was annoyed to have his case postponed, but Dr.
Jacobs says the man shook his hand and thanked him once he
explained his reasoning. "It's an airway issue — this is for your safety.
Could we handle it here? Absolutely. But if something were to go
wrong, I'd much rather have you in the hospital, where 4 other anes-
thesiologists and a respiratory therapist are available to assist."
It's easier to turf the case up to the hospital when your surgery cen-
ter literally sits at the doorstep of a 231-bed hospital. "If we were 50
4 6
O U T P A T 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 | O C T O B E R 2 0 1 5
z HANGING TOUGH "Stand your ground and do
what's best for the patient," says Dr. Jacobs.
