N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 2 7
Who's Unsafe for Outpatient Surgery?
Certain patients shouldn't get past your anesthesia gatekeepers.
A
s more and
more com-
plex proce-
dures find their way
into outpatient facili-
ties, it's crucial for
your anesthesia
providers to deter-
mine which patients
are appropriate for
same-day surgery —
and which are not.
But how do they do it? As you'll see, there's no foolproof way to
determine who's a good candidate for outpatient surgery.
Most of us are familiar with the ASA scores, but they really don't
measure operative risk (see "ASA Scores Don't Measure Operative
Risk" on page 20). Keep in mind that all outpatient facilities are not
created equal. A patient who may not be a candidate for office-based
surgery may be fine in a surgery center. And a patient who may not be
a candidate for a freestanding ASC may be fine in a hospital-based
outpatient center.
Here are some red flags and considerations when it comes to
patient selection:
• Age (But physiologic age is more important than chronological
age.)
• Abnormalities of major organ systems
• Expected difficult airways, based on Mallampati score, recessed
chin, major overbite, small mouth or large tongue
Anesthesia Alert
Perry V. Ruspantine, CRNA, APRN
• SIGNS OF TROUBLE Several factors suggest potential difficult airways, which
should be a red flag for any freestanding surgery center.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
