Joan Rivers: Endoscopy and Anesthesia Risks (cont.)

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There is not a one-size-fits-all approach to anesthesia. Patients come in all sizes and shapes, not all are young and healthy, and there are different options in using anesthesia. In a medical emergency, increased anesthetic risk is allowed because of the potentially life-threatening condition of the patient. But when the procedure is elective, there is time to decide how best to proceed in making the patient comfortable.

Outpatient office surgery/procedures are now commonplace, yet patients and families are not always aware that a procedure requiring anesthesia occurs in tandem with the procedure or surgery.

There are a variety of uses for general and local or regional anesthesia. Examples include:

  • Some dental procedures
  • Some medical procedures
  • Some screening procedures like colonoscopy and endoscopy
  • Elective surgeries such as cosmetic surgery
  • General surgery

There are risks associated with anesthesia, and preparations by the health-care team and patient are two ways to minimize the risks. However, even the best planning cannot reduce the risks of undergoing anesthesia to zero.

Standards are required for office-based anesthesia and these common practices and include:

  • Evaluate the patient's status and know what reasonable anesthetic options should be considered.
  • Explain to the patient the risks and benefits.
  • Have appropriate personnel, monitors, equipment, and medications to care for the patient.
  • "Continuous clinical observation and vigilance are the basis of safe anesthesia care."
  • Make certain that the patient recovers in a safe environment after the procedure is done.
  • Keep good records of the medical care provided.
  • Have a plan when things go wrong: adequate equipment to resuscitate the patient and protocols to call paramedics and transfer the patient to a hospital if needed.
  • "The patient has the right to dignity, respect and consideration of legitimate concerns in the office setting. Patients should be involved with all aspects of their care."

Patients and families spend significant amounts of time talking and planning with their doctor and surgeon about a potential medical procedure or surgery. The anesthetic is an afterthought and routinely, the patient meets the anesthesiologist or the nurse anesthetist on the day of the surgery. This is the person that will literally have your life in their hands as they put you to sleep, keep you sedated or paralyzed, and then wake you up when it's over. Yet, most people will only know the name of that person when they receive the bill.

Medically Reviewed by a Doctor on 12/9/2014

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