Volume 7, Issue 7 S A M B A T A L K S - PAGE 2 December, 2007

JOIN THE DISCUSSION - TOP

Need advice about a problem case in ambulatory anesthesia? Suggestions about a difficult situation in your ambulatory surgery center? A reply to questions others have raised about ambulatory anesthesia issues?

If you answered "yes" to any of these questions, or would like to share with other professionals a comment or opinion on a topic related to ambulatory anesthesia then please "Join the Discussion".

Your question, reply or comment will be published in the next available issue of SAMBA TALKS. Include your name (or initials), email address, city, and state, if you would like these published. Please note that because of the high volume of questions we receive, there is often a delay of 1 to 2 months before publication.

SAMBA Talks will include all discussion questions we receive considered of interest to the membership at large. We will endeavor to publish a response to at least one of these questions. The response will be from experts in the field, and from those willing to express a view on a particular topic, backed by experience and/or published evidence. Where email addresses are published, those individuals have indicated their interest in discussing the published questions.

Questions and responses from previous months are now available at the eNewsletter Discussion Archive. If you have any comments regarding the previous questions, please submit them to SAMBA Discussion, and they will be published here next month.

Please note: The information presented in the replies below does not represent SAMBA policy. The replies are solely the opinions of the individuals who wrote them.

?? - LAST MONTH'S QUESTION WITH REPLY - ?? - TOP

I have a question regarding equipping a multi-specialty (ortho, ENT, plastics, endo, ophthalmology) ASC. If the budget allows for only one difficult airway device, would it be appropriate to obtain a Glidescope rather than a fiberoptic bronchoscope? Assuming the ASC has LMAs, bougies and a Glidescope; can one make an argument that a fiberoptic bronchoscope is unnecessary? What are the medico-legal implications of this decision?

-- From: David Cohen (djco@comcast.net)

Reply

To quote a famous anesthesiologist: “Devices do not intubate people, people intubate people”. Clearly a device should be chosen that they are most facile with. There will always be a situation that a given person with any selection of devices will fail. Having said that, the Glidescope is generally very easy and quick to use in anesthetized patients. Flexible fiberoptic devices give you more options, but at the cost of a fragile device that requires specialized systems to clean and a good deal of skill to use.

The more important question is: Why should a center that is going to buy a lot of expensive surgical equipment (that will be used infrequently), need to sacrifice affordable anesthesia equipment that may save someone’s life? Patient safety, needs to come first.

-- From: Robert Helfand, M.D., Cleveland, OH

?? -- THIS MONTH'S QUESTION -- ?? - TOP

I am looking for a breakdown of ASA stages (or Levels) - for ambulatory surgery centers - and also am concerned about determining the highest level which we, as an ambulatory surgery center, are allowed to, or should consider for this centre. 

I would greatly appreciate any info you can give me. 

-- From: John M. Schneider, L.H.R.M. Boca Raton, FL (JohnSchneider@bellsouth.net)

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