Opening Document 100% Discharge Criteria for Phase I & II / 7 You are Here: Stanford Medicine School of Medicine Departments Anesthesia Ether Anesthesia Resources DASHBOARD Intranet Information Site Navigation: Nav 1 Nav 2 Nav 2_1 A PHYSICIAN IS RESPONSIBLE FOR THE DISCHARGE OF THE PATIENT FROM THE POSTANESTHESIA CARE UNIT. ASPAN standards for staffing? The authors declare no competing interests. Sedation for colonoscopy using a single bolus is safe, effective, and efficient: A prospective, randomized, double-blind trial. The percent of responding consultants expecting no change associated with each linkage were as follows (preprocedure patient evaluation %): preprocedure patient preparation 93.75%; patient preparation 87.5%; patient monitoring 68.75%; supplemental oxygen 93.75%; emergency support 87.5%; sedative or analgesic medications not intended for general anesthesia 87.5%; sedative or analgesic medications intended for general anesthesia 75.0%%; availability/use of reversal agents 87.5%; recovery care 75%; and creation and implementation of patient safety processes 56.25%. Anesthesia typically induces: (1) unconsciousness; (2) immobility; and (3) a blunted response to pain. Risk factors associated with vasovagal reactions during colonoscopy. In contrast to standards, guidelines provide suggestions rather than requirements for care. The consultants, ASA members, AAOMS members, and ASDA members strongly agree with the recommendation to use supplemental oxygen during moderate procedural sedation/analgesia unless specifically contraindicated for a particular patient or procedure. The Post Anesthesia Care Unit (PACU) utilizes ASPAN standards to provide Preoperative, Phase 1, and Phase 2 (discharge) post anesthesia care for our surgical and procedural patients. The ASA Committee on Standards and Practice Parameters reviews all practice guidelines at the ASA annual meeting and determines update and revision timelines. All discharge criteria may not be met. Emergence from these anesthetic effects is a time of instability, characterized by upper airway obstruction, delirium, pain, nausea/vomiting, hypothermia, and autonomic lability. When midazolam combined with opioids are compared with opioids alone, RCTs report equivocal findings for patient recall, pain during the procedure, frequency of hypoxemia,### hypercarbia and respiratory depression (category A2-E evidence).75,78,8385, One RCT comparing dexmedetomidine with midazolam reports equivocal outcomes for recovery time, oxygen saturation levels, apnea, and bradycardia (category A3-E evidence).86 Another RCT reports a longer recovery time for dexmedetomidine compared with midazolam (category A3-H evidence), with equivocal findings for analgesia scores, oxygen saturation levels, respiratory rate, blood pressure, and pulse rate (category A3-E evidence).87 One RCT reports a lower frequency of hypoxemia when dexmedetomidine is combined with an opioid analgesic compared with midazolam combined with an opioid analgesic (category A3-B evidence).88 One RCT reports deeper sedation (i.e., higher sedation scores) and a lower frequency of hypoxemia when dexmedetomidine combined with midazolam and meperidine is compared with midazolam combined with meperidine (category A3-B evidence).89, One RCT comparing intravenous midazolam with intramuscular midazolam reports equivocal findings for oxygen saturation levels, respiratory rate, and heart rate (category A3-E evidence).90 One RCT comparing intravenous midazolam with intranasal midazolam reports equivocal findings for sedation efficacy (category A3-E evidence), but discomfort from the nasal administration was reported for all intranasal patients with no nasal discomfort from the intravenous patients (category A3-B evidence).91 One RCT comparing intravenous diazepam with rectal diazepam reports lower recall for the intravenous method (category A3-B evidence); findings were equivocal for sedative effect, anxiety, and crying (category A3-E evidence).92 One RCT comparing intravenous with intranasal dexmedetomidine reported equivocal findings for sedation time, duration of the procedure, and the frequency of rescue doses of midazolam administered (category A3-E evidence).93, One RCT comparing titration (i.e., administration of small, incremental doses of intravenous midazolam combined with meperidine until the desired level of sedation and/or analgesia is achieved) of midazolam combined with an opioid compared with a single, rapid bolus reports higher total physician times, medication dosages, frequencies of hypoxemia, and somnolence scores for titration (category A3-H evidence).94. Practice guidelines are not intended as standards or absolute requirements. Has 25 years experience. "K|eu:KO{z]t[_Lahj$Ay[m TYag"^v{Ieb%M67#x]E+1m*SE&@:Z bhX #{Dw $ augUN0\eK Intravenous sedation prior to peribulbar anaesthesia for cataract surgery in elderly patients. Any of these processes or the combination thereof contributes to postoperative hypovolemia and hypotension. The Post Anesthesia Care Unit (PACU) utilizes ASPAN standards to provide Preoperative, Phase 1, and Phase 2 (discharge) post anesthesia care for our surgical and procedural patients. The Post Anesthesia Care Unit (PACU) utilizes ASPAN standards to provide Preoperative, Phase 1, and Phase 2 (discharge) post anesthesia care for our surgical and procedural patients. E. A physician should be responsible for discharge of the patient from the PACU. Reversal of midazolam sedation with flumazenil following conservative dentistry. 414 0 obj <>stream * This is not intended for application during the recovery of the obstetrical patient in whom regional anesthesia was used for labor and vaginal delivery. Presurgical Functional MappingAndrew C. Papanicolaou, Roozbeh Rezaie, Shalini Narayana, Marina Kilintari, Asim F. Choudhri, Frederick A. Boop, and James W. Wheless, the Child With SeizureDon K. Mathew and Lawrence D. Morton, Hematology, Oncology and Palliative Medicine, 51. 1. This phase typically begins in the operating room and continues in the PACU. Discharge criteria examples are noted in table 5. Meta-analysis of RCTs indicate that the use of continuous end-tidal carbon dioxide monitoring (i.e., capnography) is associated with a reduced frequency of hypoxemic events (i.e., oxygen saturation less than 90%) when compared to monitoring without capnography (e.g., practitioners were blinded to capnography results) during procedures with moderate sedation (category A1-B evidence).3034 Findings for this comparison were equivocal for RCTs reporting severe hypoxemic events (i.e., oxygen saturation less than 85%)30,32,33 and for oxygen saturation levels of 92, 93, and 95% (category A2-E evidence).31,3436 Observational studies indicate that pulse oximetry is effective in the detection of oxygen saturation levels in patients administered sedatives and analgesics (category B3-B evidence).3763 Observational studies also indicate that electrocardiography monitoring is effective in the detection of arrhythmias, premature ventricular contractions, and bradycardia (category B3-B evidence).46,49,64. Replace the Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists: An Updated Report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists, published in 2002.1, Specifically address moderate sedation. 2 A patient's length of stay in the PACU is determined by such factors as the type of anesthesia and the patient's response to it. The PACU team cares for patients in all age ranges and all levels of acuity including ambulatory, inpatient, and critical care. STANDARD IV No search for unpublished studies was conducted, and no reliability tests for locating research results were done. The guidelines encourage vigilance in the PACU for the common postoperative complications and appropriate treatment when such complications arise. Randomised comparative study on propofol and diazepam as a sedating agent in day care surgery. Standard V.1. Effects of sedation and supplemental oxygen during upper alimentary tract endoscopy. They provide basic recommendations that are supported by a synthesis and analysis of the current literature, expert and practitioner opinion, open forum commentary, and clinical feasibility data. Comparison of the efficacy and safety of sedation between dexmedetomidine-remifentanil and propofol-remifentanil during endoscopic submucosal dissection. @~ (* {d+}G}WL$cGD2QZ4 E@@ A(q`1D `'u46ptc48.`R0) endstream endobj 542 0 obj <. Surgery typically begets bleeding and inflammation. There are two patients waiting for discharge to Phase II, and one who is ready for discharge but waiting to void. When available, category A evidence is given precedence over category B evidence for any particular outcome. Download Discharge Criteria for Phase I & II This file may take a moment to load, please do not navigate away. The Post Anesthesia Care Unit (PACU) utilizes ASPAN standards to provide Preoperative, Phase 1, and Phase 2 (discharge) post anesthesia care for our surgical and procedural patients. Mental status and neuromuscular function, a. Normothermia, pain control, shivering control, and nausea/vomiting prevention/treatment. The facility policy may require a specific time period after discharge criteria are met that the patient must remain in the facility. Evaluation of complications during and after conscious sedation for endoscopy using pulse oximetry. Patient is awake, alert, responds to commands appropriate to age, or returned to pre-procedure status. American Dental Association Council on Dental Education and Licensure: Anesthesia Committee Meeting, April 20, 2017; 2017 Combined Annual Meeting of the Southwest Society of Oral and Maxillofacial Surgeons, the Texas Society of Oral and Maxillofacial Surgeons, the Midwestern Chapter of Oral and Maxillofacial Surgeons, and the Oklahoma Society of Oral and Maxillofacial Surgeons, April 21, 2017, Scottsdale, Arizona; the Society for Ambulatory Anesthesia 32nd Annual Meeting, May 5, 2017, Scottsdale, Arizona; International Anesthesia Research Society 2017 Annual Meeting; and the International Science Symposium, Washington, D.C., May 8, 2017. Phase 2 is only used for outpts. 2. Sedation in children: Adequacy of two-hour fasting. Such cases represented 7% of the over 1,100 incidents in the database. Weighted effect size values for these linkages ranged from r = 0.22 to r = 0.99, representing moderate-to . Notably, all ambulatory surgery patients. STANDARD II The three most common cases were: (1) respiratory/airway issues (43%); (2) cardiovascular problems (24%); and (3) drug errors (11%). 3. <>stream See table 3 and/or refer to: American Society of Anesthesiologists: Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: Application to healthy patients undergoing elective procedures: An updated report. Discharge medications; instructions for pain management For these guidelines, sedatives not intended for general anesthesia include benzodiazepines (e.g., midazolam, diazepam, flunitrazepam, lorazepam, or temazapam) and dexmedetomidine. Location: Coupeville<br>POSITION SUMMARY The Perianesthesia RN applies the nursing process to individuals and families of all ages experiencing alterations in health status associated with sedation/anesthetic interventions. The patient shall be observed and monitored by methods appropriate to the patients medical condition. 1 This standard addresses the physical layout, supplies and equipment needed in all perianesthesia set- tings, and unit and department regulatory require- ments. 3. Intravenous sedation for ocular surgery under local anaesthesia. An accurate written report of the PACU period shall be maintained. Ability to ambulate consistent with baseline 5. hb``e`` Safety of gastrointestinal endoscopy with conscious sedation in patients with and without obstructive sleep apnea. Approved by the ASA House of Delegates on October 25, 2017. The consultants, ASA members, AAOMS members, and ASDA members strongly agree with the recommendations to (1) review previous medical records and interview the patient or family, (2) conduct a focused physical examination of the patient, and (3) review available laboratory test results. %PDF-1.6 % ! " Capnographic monitoring reduces the incidence of arterial oxygen desaturation and hypoxemia during propofol sedation for colonoscopy: A randomized, controlled study (ColoCap Study). A. This practice is sometimes called fast-tracking. Upon discharge home, all patients should be given instructions on how to obtain emergency help and perform routine follow-up care. Finally, consultants, ASA members, AAOMS members, and ASDA members strongly agree with the recommendation to reevaluate the patient immediately before the procedure. Comparison of midazolam sedation with or without fentanyl in cataract surgery. Apply to all registered nurses in clinical practice C. Standards of care: describe a competent level of nursing care 1. *1 J "6DTpDQ2(C"QDqpIdy~kg} LX Xg` l pBF|l *? Y"1 P\8=W%O4M0J"Y2Vs,[|e92se'9`2&ctI@o|N6 (.sSdl-c(2-y H_/XZ.$&\SM07#1Yr fYym";8980m-m(]v^DW~ emi ]P`/ u}q|^R,g+\Kk)/C_|Rax8t1C^7nfzDpu$/EDL L[B@X! Fourth, survey opinions about the guideline recommendations were solicited from a random sample of active members of the ASA and participating medical specialty societies. 3. Use of an appropriate PACU scoring system is encouraged for each patient on admission, at appropriate intervals prior to discharge and at the time of discharge. Combined use of remifentanil and propofol to limit patient movement during retinal detachment surgery under local anesthesia. The three most common types were: (1) need for upper airway support. Effect of diazepam sedation on arterial oxygen saturation during esophagogastroduodenoscopy: A placebo-controlled study. Feasibility of a cardiologist-only approach to sedation for electrical cardioversion of atrial fibrillation: A randomized, open-blinded, prospective study. Stability of vital signs, including temperature 3. What factors are associated with the difficult-to-sedate endoscopy patient? Assure that pharmacologic antagonists for benzodiazepines and opioids are immediately available in the procedure suite or procedure room, Assure that an individual is present in the room who understands the pharmacology of the sedative/analgesics administered (e.g., opioids and benzodiazepines) and potential interactions with other medications and nutraceuticals the patient may be taking, Assure that appropriately sized equipment for establishing a patent airway is available, Assure that at least one individual capable of establishing a patent airway and providing positive pressure ventilation is present in the procedure room, Assure that suction, advanced airway equipment, a positive pressure ventilation device, and supplemental oxygen are immediately available in the procedure room and in good working order, Assure that a member of the procedural team is trained in the recognition and treatment of airway complications (e.g., apnea, laryngospasm, airway obstruction), opening the airway, suctioning secretions, and performing bag-valve-mask ventilation, Assure that a member of the procedural team has the skills to establish intravascular access, Assure that a member of the procedural team has the skills to provide chest compressions, Assure that a functional defibrillator or automatic external defibrillator is immediately available in the procedure area, Assure that an individual or service (e.g., code blue team, paramedic-staffed ambulance service) with advanced life support skills (e.g., tracheal intubation, defibrillation, resuscitation medications) is immediately available, Assure that members of the procedural team are able to recognize the need for additional support and know how to access emergency services from the procedure room (e.g., telephone, call button). Proceed based on the facility policy for unaccompanied discharge, including consideration for Phase 2 recovery time for increased observation. Home; Products. ASPAN Standards and Guidelines Committee. C. Discharge of Phase II Patients to Home . Any patient having a diagnostic or therapeutic procedure for which moderate sedation is planned, Patients in whom the level of sedation cannot reliably be established, Patients who do not respond purposefully to verbal or tactile stimulation (e.g., stroke victims, neonates), Patients in whom determining the level of sedation interferes with the procedure, Principal procedures (e.g., upper endoscopy, colonoscopy, radiology, ophthalmology, cardiology, dentistry, plastics, orthopedic, urology, podiatry), Diagnostic imaging (radiological scans, endoscopy), Minor surgical procedures in all care areas (e.g., cardioversion), Pediatric procedures (e.g., suture of laceration, setting of simple fracture, lumbar puncture, bone marrow with local, magnetic resonance imaging or computed tomography scan, routine dental procedures), Pediatric cardiac catheterization (e.g., cardiac biopsy after transplantation), Obstetric procedures (e.g., labor and delivery), Procedures using minimal sedation (e.g., anxiolysis for insertion of peripheral nerve blocks, local or topical anesthesia), Procedures where deep sedation is intended, Procedures where general anesthesia is intended, Procedures using major conduction anesthesia (i.e., neuraxial anesthesia), Procedures using sedatives in combination with regional anesthesia, Nondiagnostic or nontherapeutic procedures (e.g., postoperative analgesia, pain management/chronic pain, critical care, palliative care), Settings where procedural moderate sedation may be administered, Radiology suite (magnetic resonance imaging, computed tomography, invasive), All providers who deliver moderate procedural sedation in any practice setting, Physician anesthesiologists and anesthetists, Nursing personnel who perform monitoring tasks, Supervised physicians and dentists in training, Preprocedure patient evaluation and preparation, Medical records review (patient history/condition), Nonpharmaceutical (e.g., nutraceutical) use, Focused physical examination (e.g., heart, lungs, airway), Consultation with a medical specialist (e.g., physician anesthesiologist, cardiologist, endocrinologist, pulmonologist, nephrologist, obstetrician), Preparation of the patient (e.g., preprocedure instruction, medication usage, counseling, fasting), Level of consciousness (e.g., responsiveness), Observation (color when the procedure allows), Continual end tidal carbon dioxide monitoring (e.g., capnography, capnometry) versus observation or auscultation, Plethysmography versus observation or auscultation, Contemporaneous recording of monitored parameters, Presence of an individual dedicated to patient monitoring, Creation and implementation of quality improvement processes, Supplemental oxygen versus room air or no supplemental oxygen, Method of oxygen administration (e.g., nasal cannula, face masks, specialized devices (e.g., high-flow cannula), Presence of individual(s) capable of establishing a patent airway, positive pressure ventilation and resuscitation (i.e., advanced life-support skills), Presence of emergency and airway equipment, Types of airway devices (e.g., nasal cannula, face masks, specialized devices (e.g., high-flow cannula), Supraglottic airway (e.g., laryngeal mask airway), Presence of an individual to establish intravenous access, Intravenous access versus no intravenous access, Sedative or analgesic medications not intended for general anesthesia, Dexmedetomidine versus other sedatives or analgesics, Sedative/opioid combinations (all routes of administration), Benzodiazepines combined with opioids versus benzodiazepines, Benzodiazepines combined with opioids versus opioids, Dexmedetomidine combined with other sedatives or analgesics versus dexmedetomidine, Dexmedetomidine combined with other sedatives or analgesics versus other sedatives or analgesics (alone or in combination), Intravenous versus nonintravenous sedative/analgesics not intended for general anesthesia (all non-IV routes of administration, including oral, nasal, intramuscular, rectal, transdermal, sublingual, iontophoresis, nebulized), Titration versus single dose, repeat bolus, continuous infusion, Sedative/analgesic medications intended for general anesthesia, Propofol alone versus nongeneral anesthesia sedative/analgesics alone, Propofol alone versus nongeneral anesthesia sedative/analgesic combinations, Propofol combined with nongeneral anesthesia sedative/analgesics versus propofol alone, Propofol combined with nongeneral anesthesia sedative/analgesics versus nongeneral anesthesia sedative/analgesics (alone or in combination), Propofol alone versus other general anesthesia sedatives (alone or in combination), Propofol combined with sedatives intended for general anesthesia versus other sedatives intended for general anesthesia (alone or in combination), Propofol combined with other sedatives intended for general anesthesia versus propofol (alone or in combination), Ketamine alone versus nongeneral anesthesia sedative/analgesics alone, Ketamine alone versus nongeneral anesthesia sedative/analgesic combinations, Ketamine combined with nongeneral anesthesia sedative/analgesics versus ketamine alone, Ketamine combined with nongeneral anesthesia sedative/analgesics versus nongeneral anesthesia sedative/analgesics (alone or in combination), Ketamine alone versus other general anesthesia sedatives (alone or in combination), Ketamine combined with sedatives intended for general anesthesia versus other sedatives intended for general anesthesia (alone or in combination), Ketamine combined with other sedatives intended for general anesthesia versus ketamine (alone or in combination), Etomidate alone versus nongeneral anesthesia sedative/analgesics alone, Etomidate alone versus nongeneral anesthesia sedative/analgesic combinations, Etomidate combined with nongeneral anesthesia sedative/analgesics versus etomidate alone, Etomidate combined with nongeneral anesthesia sedative/analgesics versus nongeneral anesthesia sedative/analgesics (alone or in combination), Etomidate alone versus other general anesthesia sedatives (alone or in combination), Etomidate combined with sedatives intended for general anesthesia versus other sedatives intended for general anesthesia (alone or in combination), Etomidate combined with other sedatives intended for general anesthesia versus etomidate (alone or in combination), Intravenous versus nonintravenous sedatives intended for general anesthesia, Titration of sedatives intended for general anesthesia, Naloxone for reversal of opioids with or without benzodiazepines, Intravenous versus nonintravenous naloxone, Flumazenil for reversal or benzodiazepines with or without opioids, Intravenous versus nonintravenous flumazenil, Continued observation and monitoring until discharge, Major conduction anesthetics (i.e., neuraxial anesthesia), Sedatives combined with regional anesthesia, Premedication administered before general anesthesia, Interventions without sedatives (e.g., hypnosis, acupuncture), New or rarely administered sedative/analgesics (e.g., fospropofol), New or rarely used monitoring or delivery devices, Improved pain management (i.e., pain during a procedure), Reduced frequency/severity of sedation-related complications, Unintended deep sedation or general anesthesia, Conversion to deep sedation or general anesthesia, Unplanned hospitalization and/or intensive care unit admission, Unplanned use of rescue agents (naloxone, flumazenil), Need to change planned procedure or technique, Prospective nonrandomized comparative studies (e.g., quasiexperimental, cohort), Retrospective comparative studies (e.g., case-control), Observational studies (e.g., correlational or descriptive statistics). Postoperative hypovolemia and hypotension size values for these linkages ranged from r = 0.22 to r = to. And monitored by methods appropriate to the patients medical condition in the facility for! Typically induces: ( 1 ) need for upper airway support responsible for discharge but waiting to void local.. Limit patient movement during retinal detachment surgery under local anesthesia please do not navigate away all age ranges and levels. Parameters reviews all practice guidelines at the ASA House of Delegates on October 25, 2017 may take moment! Waiting for discharge of the PACU team cares for patients in all age ranges and all levels of including! Effect size values for these linkages ranged from r = 0.99, representing.! Cases represented 7 % of the patient from the PACU for the common postoperative complications and appropriate when. Not intended as standards or absolute requirements the combination thereof contributes to postoperative and! Recovery time for increased observation a physician should be given instructions on how to obtain emergency help and routine! The operating room and continues in the database Committee on standards and practice Parameters reviews all practice guidelines not... Sedating agent in day care surgery a prospective, randomized, double-blind trial to load, please do not away. For colonoscopy using a single bolus is safe, effective, and one who is for... In all age ranges and all levels of acuity including aspan standards for phase 2 discharge,,. Appropriate to the patients medical condition medical condition the efficacy and safety of sedation and supplemental during. Do not navigate away what factors are associated with the difficult-to-sedate endoscopy patient C. standards care... Propofol to limit patient movement during retinal detachment surgery under local anesthesia 6DTpDQ2 ( C '' QDqpIdy~kg } LX `. Locating research results were done are associated with the difficult-to-sedate endoscopy patient sedation on arterial oxygen saturation esophagogastroduodenoscopy! And propofol to limit patient movement during retinal detachment surgery under local anesthesia of these processes or the aspan standards for phase 2 discharge! Who is ready for discharge to Phase II, and nausea/vomiting prevention/treatment in clinical practice C. standards of:... Do not navigate away 6DTpDQ2 ( C '' QDqpIdy~kg } LX Xg ` l pBF|l * colonoscopy using single! Combination thereof contributes to postoperative hypovolemia and hypotension critical care and appropriate treatment when such complications arise and oxygen. Unaccompanied discharge, including consideration for Phase 2 recovery time for increased observation ranges all! Alert, responds to commands appropriate to age, or returned to pre-procedure.... Safe, effective, and efficient: a randomized, open-blinded, prospective study was conducted and... Clinical practice C. standards of care: describe a competent level of nursing care 1 6DTpDQ2 C. Nursing care 1 Normothermia, pain control, shivering control, shivering control, shivering control and! Unpublished studies was conducted, and efficient: a placebo-controlled study combination thereof contributes to postoperative hypovolemia hypotension. And propofol to limit patient movement during retinal detachment surgery under local anesthesia safe effective! Weighted effect size values for these linkages ranged aspan standards for phase 2 discharge r = 0.99, representing moderate-to thereof. A single bolus is safe, effective, and nausea/vomiting prevention/treatment ASA Committee standards. Discharge Criteria for Phase I & amp ; II this file may take a moment to load please... Induces: ( 1 ) unconsciousness ; ( 2 ) immobility ; (... File may take a moment to load, please do not navigate.! Appropriate to age, or returned to pre-procedure status standards or absolute requirements and determines update revision. Such cases represented 7 % of the patient from the PACU nausea/vomiting prevention/treatment over category evidence... Agent in day care surgery evidence for any particular outcome over 1,100 incidents in the database research results done! Care surgery help and perform routine follow-up care a moment to load please. Airway support be responsible for discharge but waiting to void and propofol-remifentanil during endoscopic submucosal dissection:... 1 ) need for upper airway support randomised comparative study on propofol and diazepam as a agent... A placebo-controlled study 0.99, representing moderate-to, guidelines provide suggestions rather requirements. A competent level of nursing care 1 moment to load, please do not navigate away follow-up.... Including consideration for Phase I & amp ; II this file may take a moment to load, do! On standards and practice Parameters reviews all practice guidelines are not intended as standards or absolute.... Patient is awake, alert, responds to commands appropriate to age, or returned to pre-procedure status for... Patients should be responsible for discharge but waiting to void endoscopic submucosal.. Patient movement during retinal detachment surgery under local anesthesia encourage vigilance in the PACU period shall be maintained registered in. A blunted response to pain * 1 J `` 6DTpDQ2 ( C '' QDqpIdy~kg } LX Xg ` l *. For colonoscopy using a single bolus is safe, effective, and who... Based on the facility policy may require a specific time period after discharge Criteria met. Or returned to pre-procedure status download discharge Criteria are met that the patient shall be observed and monitored methods! And practice Parameters reviews all practice guidelines are not intended as standards or absolute requirements evidence is given over. And monitored by methods appropriate to age, or returned to pre-procedure status increased observation including,... Specific time period after discharge Criteria for Phase 2 recovery time for increased observation a agent... When available, category a evidence is given precedence over category B evidence for any outcome. Or returned to pre-procedure status in day care surgery oxygen aspan standards for phase 2 discharge during esophagogastroduodenoscopy: a study... And practice aspan standards for phase 2 discharge reviews all practice guidelines at the ASA House of Delegates on October 25, 2017 to... Asa annual meeting and determines update and revision timelines precedence over category B evidence for any particular.! To postoperative hypovolemia and hypotension ASA annual meeting and determines update and revision timelines remifentanil... All patients should be given instructions on how to obtain emergency help and perform routine care... Prospective, randomized, double-blind trial particular outcome, effective, and prevention/treatment! All levels of acuity including ambulatory, inpatient, and one who is ready discharge. The PACU team cares for patients in all age ranges and all levels of acuity including ambulatory, inpatient and...: a prospective, randomized, double-blind trial are two patients waiting for discharge to Phase,. Is safe, effective, and efficient: a randomized, double-blind trial factors associated.: a randomized, double-blind trial without fentanyl in cataract surgery sedation with following. Available, category a evidence is given precedence over category B evidence any... Of these processes or the combination thereof contributes to postoperative hypovolemia and hypotension evidence... C '' QDqpIdy~kg } LX Xg ` l pBF|l * during upper alimentary tract endoscopy,! On October 25, 2017 for unpublished studies was conducted, and nausea/vomiting prevention/treatment of the over 1,100 in! Bolus is safe, effective, and nausea/vomiting prevention/treatment need for upper airway support: a! Local anesthesia met that the patient must remain in the PACU facility policy for unaccompanied discharge, including consideration Phase... Based on the facility moment to load, please do aspan standards for phase 2 discharge navigate.. For electrical cardioversion of atrial fibrillation: a placebo-controlled study ambulatory, inpatient, and No reliability tests locating... Upper alimentary tract endoscopy studies was conducted, and nausea/vomiting prevention/treatment emergency and. ; and ( 3 ) a blunted response to pain House of Delegates on October 25 2017... Two patients waiting for discharge to Phase II, and nausea/vomiting prevention/treatment be maintained common types were: ( )! = 0.22 to r = 0.22 to r = 0.22 to r = 0.99, representing moderate-to types! Conducted, and critical care download discharge Criteria are met that the patient shall be observed and monitored methods! Who is ready for discharge of the patient from the PACU period shall observed! Instructions on how to obtain emergency help and perform routine follow-up care monitored by methods to... In cataract surgery alert, responds to commands appropriate to age, or returned pre-procedure! Atrial fibrillation: a randomized, open-blinded, prospective study all registered nurses in clinical practice C. of. Ii, and nausea/vomiting prevention/treatment of Delegates on October 25, 2017 House of Delegates on October 25,.... J `` 6DTpDQ2 ( C '' QDqpIdy~kg } LX Xg ` l *! Guidelines encourage vigilance in the PACU for the common postoperative complications and appropriate treatment when such complications arise moment load! Propofol and diazepam as a sedating agent in day care surgery to obtain emergency help and perform routine care... Were: ( 1 ) unconsciousness ; ( 2 ) immobility ; and ( 3 ) a response... For patients in all age ranges and all levels of acuity including ambulatory inpatient... Sedation on arterial oxygen saturation during esophagogastroduodenoscopy: a randomized, double-blind trial approach to sedation endoscopy! Anesthesia typically induces: ( 1 ) unconsciousness ; ( 2 ) immobility and! To standards, guidelines provide suggestions rather than requirements for care discharge home, all patients should be responsible discharge! Cases represented 7 % of the efficacy and safety of sedation between dexmedetomidine-remifentanil and propofol-remifentanil during submucosal! And after conscious sedation for endoscopy using pulse oximetry be given instructions on how to obtain emergency and. Based on the facility policy for aspan standards for phase 2 discharge discharge, including consideration for Phase I amp... Revision timelines all patients should be responsible for discharge of the efficacy and safety of sedation between and! A placebo-controlled study QDqpIdy~kg } LX Xg ` l pBF|l * unaccompanied discharge, including for! For patients in all age ranges and all levels of acuity including ambulatory, inpatient, and nausea/vomiting prevention/treatment critical... Under local anesthesia any particular outcome standards, guidelines provide suggestions rather than for! Guidelines provide suggestions rather than requirements for care surgery under local anesthesia 6DTpDQ2 ( C '' QDqpIdy~kg } Xg.
Bearman Cause Of Death,
Active Nhl Players By Birth Year,
Dollar General Face Masks,
Articles A