NonOR Anesthesia Flashcards
Which nonOR procedural area has more malpractice claims for death compared with OR settings?
GI Suite
Approximately what % of all anesthetics occur outside the OR?
~55%
NonOR anesthesia offers what kind of services?
Full range of anesthesia to all age groups
What NonOR adverse event had more closed claims than OR?
Death lol
How do standards of care in NonOR anesthesia compare to OR?
They don’t! They have the exact same standards.
What are the A-J (or 10) standards of NonOR anesthesia care
A. Preanesthesia Assessment
B. Obtain Informed Consent
C. Form a Patient-Specific Anesthesia Plan
D. Implement/Adjust the Plan based on pt response
E. Prepare, Dispense, and Label all Medications to be used
F. Adhere to safety precautions
G. Monitor and Document pt condition
H. Infection Control
I. Complete, Accurate, Timely Documentation
J. Transfer, continuity of care
Only what kind of anesthesia ensures amnesia?
General Anesthesia. So, discuss expectations with the patient.
When is temperature monitoring required vs optional in NonOR?
Required with general anesthesia. Optional during mild, moderate, or deep.
In cases of moderate or deep sedation, AANA and ASA mandate the measurement of?
etCO2
What must the anesthesia provider do before leaving the patient in the recovery area?
Thoroughly assess the stability of the patient and airway maintenance
Minimal Sedation was formerly known as?
Anxiolysis
During minimal sedation, what are the effects on:
Responsiveness,
Airway,
Spontaneous Ventilation, and
Cardiovascular Function
Responsiveness: Normal response to verbal stimuli. Some cognitive function and coordination may be impaired.
Airway: Unaffected
Spontaneous Ventilation: Unaffected
Cardiovascular Function: Unaffected
Moderate Sedation/Analgesia was formerly known as?
Conscious sedation
During moderate sedation, what are the effects on:
Responsiveness,
Airway,
Spontaneous Ventilation, and
Cardiovascular Function
Responsiveness: Purposeful response to verbile OR tactile stimulation.
Airway: No intervention required
Spontaneous Ventilation: Adequate
Cardiovascular Function: Usually maintained
Is reflexive withdrawal from a painful stimulus considered a purposeful response?
No, not considered purposeful
During Deep Sedation/Analgesia, what are the effects on:
Responsiveness,
Airway,
Spontaneous Ventilation, and
Cardiovascular Function
Responsiveness: Purposeful response following repeated or painful stimulation
Airway: Intervention may be required
Spontaneous Ventilation: May be inadequate
Cardiovascular: Usually maintained
What is deep sedation/analgesia?
Drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully after repeated or painful stimulation.
During General Anesthesia, what are the effects on:
Responsiveness,
Airway,
Spontaneous Ventilation, and
Cardiovascular Function
Responsiveness: Unarousable even with painful stimulation
Airway: Intervention often required
Spontaneous Ventilation: Frequently Inadequate
Cardiovascular: May be impaired
During anesthesia, what causes patients to need airway or ventilatory support?
Assistance maintaining a patent airway and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function.
In NonOR anesthesia cases, what is one of the most common minor adverse events?
Inadequate pain control
Children under ____ years old seem to be at the greatest risk for adverse events even with no underlying disease
Under the age of 5!
The goals of nonoperating room anesthesia, no matter the environment, are:
- Get familiar with the environment
- As safe as the operating room
What is one of the most common reasons for adverse events in pediatrics?
use of multiple drugs, especially sedative medication
What problems are most often encountered with adverse events in pediatrics?
Respiratory events: depression, obstruction, apnea
