Preoperative Assessment Guidelines for Outpatient Surgery Centers
All patients will be assessed prior to the procedure day by a nurse specialist, working in conjunction with an anesthesiologist. The following are our guidelines for preparing patients for procedures at outpatient surgery centers to ensure patient safety.
When does a patient need an ECG before an outpatient procedure?
• Patients over age 60 and anyone with symptomatic heart disease should have a baseline ECG within the past year. Exceptions include cataract surgery, endoscopy, pain management procedures, and other minor procedures requiring only MAC anesthesia.
When should routine labs be ordered for outpatient procedures?
• Urine HCG for females in reproductive years on the day of the procedure.
• Glucose testing on admission for diabetics.
• Recent hemoglobin required only for those with recent bleeding or anemia.
• Recent potassium required only for those with end stage renal failure.
• Coagulation studies are required if the patient is on anticoagulants and the procedure warrants it.
When is a chest x-ray necessary for an outpatient procedure?
• Chest x-rays are not required for surgery center cases.
What is the upper limit of BMI for patients the surgery center?
• The upper limit of BMI varies depending on the type of procedure and modality of anesthesia required.
Can patients with obstructive sleep apnea have procedures at the surgery center?
• Yes. Patients who use a CPAP machine should bring it with them on the day of surgery.
When might a patient having an outpatient procedure need a consultation with a specialist as part of their preoperative assessment?
Some examples of medical problems that will require further preoperative assessment are the following:
- Congestive Heart Failure
- Recent angioplasty or cardiac stenting
- Lung disease requiring home oxygen
- Neuromuscular disorders
- History of difficult intubation