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V A WESTERN NEW YORK HEALTHCARE SYSTEM

SCOPE OF CARE

PERIOPERATIVE CARE & ANESTHESIOLOGY SERVICE

2001

DEFINITION:

Anesthesiology is the art and science of rendering a patient insensible to pain by the administration of anesthetic agents and related drugs and procedures. Anesthesia and perioperative care represents those services which anesthesia professionals provide upon request, assignment or referral, most often to facilitate diagnostic, therapeutic or surgical interventions. In other instances, the referral or request for consultation or assistance may be for management of acute or chronic pain.

Anesthesia providers practice according to their expertise, and institutional policy. Anesthesia and Perioperative care is administered in four general categories: 1) preanesthetic preparation and evaluation, 2) daily OR management and surgical scheduling 3) anesthesia induction, maintenance and emergence, 3) postanesthetic care and recovery 4) perianesthetic and clinical support functions, 5) Critical Care Medicine, and 6) Pain Medicine.

SCOPE OF CARE AND SERVICE:

The scope of care includes, but is not limited to the following:

A. Performing and documenting a preanesthetic assessment and evaluation of the patient, including requesting consultations and diagnostic studies, selecting, obtaining, ordering, or administering preanesthetic medications and fluids, and obtaining informed consent for anesthesia.

B. Developing and administering an anesthetic plan, which may include General, Regional, or Local anesthesia and intravenous sedation.

C. Selecting, obtaining, or administering the anesthetics, adjuvant drugs, accessory drugs, and fluids necessary to manage the anesthetic, to maintain the patients physiologic homeostasis, and to correct responses to the anesthetic or surgery.

D. Selecting, applying or inserting appropriate noninvasive and invasive monitoring modalities for collecting and interpreting patient physiological data.

E. Appropriately managing a patient's airway.

F. Managing emergence and recovery from anesthesia by selecting, obtaining, ordering, or administering medications, fluids, or ventilatory support in order to maintain physiologic homeostasis, to provide relief from pain, anesthesia side effects, and to prevent or manage complications.

G. Releasing or discharging patients from a post anesthesia care area, and providing postanesthesia follow-up evaluation and appropriate care.

H. Ordering, initiating or modifying pain relief therapy, through the utilization of appropriate diagnostic and therapeutic modalities.

I. Responding to cardio-pulmonary emergency situations.

J. Consultative care for the critically ill.

K Consultative services for pain management.

CUSTOMERS SERVED:

1. All patients requiring anesthesia care.

2. Surgical Services

3. The clinical supervision, teaching and evaluation of healthcare providers:

    · Anesthesiology Residents

    · Graduate Student Nurse Anesthetists

    · Other Residents (Internal Medicine, Surgery, Dental, Podiatry, etc.)

    · Therapists ( Respiratory)

    · Medical/Nursing Students

4. Interdisciplinary collaboration with appropriate Services through a continuous quality improvement (TQI) program to improve the efficiency and effectiveness of patient care.

REVIEW DATE: January 2002