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Chapter 25 - Sedation in the Office and Other Outpatient Settings

Published online by Cambridge University Press:  12 December 2024

Richard D. Urman
Affiliation:
Ohio State University
Alan David Kaye
Affiliation:
Louisiana State University School of Medicine
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Summary

The office or outpatient setting as a site for procedures is, metaphorically, a small lifeboat (not a pirate ship!) on the high seas away from port and the mothership, far from immediate aid. Whether the site is a detached procedural area on the campus of a large medical center, or a procedure room in a physician’s office, the metaphor is appropriate. The lifeboat and her crew must be capable and equipped to handle emergencies without immediate help from the outside. At a medical center, even a detached outpatient procedural area may have access to a rapid response team with rescue capabilities. However, such advanced emergency support teams will not be as close as they would be if the procedure were taking place in the main hospital. Help may be even more distant when working at a freestanding outpatient surgical suite or a physician’s office, when the municipal emergency response system (911) must be activated. Therefore, the crew of the lifeboat must be prepared to perform the primary resuscitation as they are the first responders.

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Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Gawande, A. The Checklist Manifesto: How to Get Things Right. New York, NY: Metropolitan Books, 2009.Google Scholar
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American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Practice guidelines for moderate procedural sedation and analgesia 2018: a Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology 2018; 128: 437–79.Google Scholar

Additional Reading

Catchpole, K, Mishra, A, Handa, A, McCulloch, P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg. 2008;247:699706.CrossRefGoogle ScholarPubMed
Jani, SR, Shapiro, FE, Gabriel, RA, et al. A comparison between office and other ambulatory practices: analysis from the National Anesthesia Clinical Outcomes Registry. J Healthc Risk Manag. 2016; 35(4):3847.CrossRefGoogle ScholarPubMed
Nestel, D, Kidd, J. Nurses’ perceptions and experiences of communication in the operating theatre: a focus group interview. BMC Nurs. 2006;5 1.CrossRefGoogle ScholarPubMed
Ogg, M, Burlingame, B. Clinical issues: recommended practices for moderate sedation/analgesia. AORN J. 2008;88:275–7.CrossRefGoogle Scholar
Reynolds, A, Timmons, S. The doctor–nurse relationship in the operating theatre. Br J Perioper Nurs. 2005;15:110–15.Google ScholarPubMed
Shapiro, FE, Jani, SR, Liu, X, Dutton, RP, Urman, RD. Initial results from the National Anesthesia Clinical Outcomes Registry and overview of office-based anesthesia. Anesthesiol Clin. 2014; 32(2):431–44.CrossRefGoogle ScholarPubMed
Shapiro, FE, Punwani, N, Rosenberg, NM, et al. Office-based anesthesia: safety and outcomes. Anesth Analg. 2014;119(2):276–85.CrossRefGoogle ScholarPubMed

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