| Abstract: |
there are some unique and specific responsibilities that should be considered prior to administration of anesthesia in the office setting. When considering an office based practice, anesthesia practitioners should determine if there are appropriate resources to manage the various levels of anesthesia for the planned surgical procedures and the condition of the patient. Most office based practice settings are not regulated, therefore, the anesthetists should consider the benefit of uniform professional standards regarding practitioner qualifications, training, equipment, facilities and policies that ensure the safety of the patient during operative and anesthesia procedures in the office setting.Informed Consent: Informed consent of the patient and/or, if applicable, the patient’s representative, should be obtained before surgery. Informed consent should only be obtained after a discussion of risks, benefits and alternatives and should be documented in the patient’s health record.These specific responsibilities that should be considered prior to administration of anesthesia in the office setting are.1.Patient Assessment1.1 The patient should be assessed before the procedure.Documentation should include:• A concise medical history and examination (including blood pressure measurement)• Informed consent• Any instructions for preparation and discharge procedure1.2 If the patient has any serious medical condition or danger of airway compromise, or is a young child or is elderly, then an anaesthetist should be present to monitor the patient during the procedure.1.3 Patient assessment can be assisted by:• A standardised anaesthetic questionnaire• Preliminary nurse assessment• Prior anaesthetic referral in cases of doubt as to suitability for office based surgery.1.4 Patient information in an understandable written format must include:• General information about the procedures followed in the office based facility• Limited solid food may be taken up to six hours prior to operation• Unsweetened clear fluids totalling not more than 200 ml per hour may be taken up to three hours prior to operation• Only medications or water ordered by the anaesthetist should be taken less than three hours prior to operation• An H2-receptor antagonist should be considered for patients with an increased risk of gastric regurgitation• These guidelines may be modified for some patients, particularly infants and small children, on advice from the anaesthetist.
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