Monitors and Equipment for the Ambulatory Surgical Care Setting
As Ambulatory Surgical Centers (ASC) become increasingly popular in the United States, proper anesthesia equipment and monitoring are foundational for ensuring the delivery of safe and efficient anesthetic care. Herein, we will review standard and expected monitoring every ASC should consider in order to meet their stated mission, including pulse oximetry, non-invasive blood pressure, electrocardiographic, temperature and capnographic monitoring. We will also discuss the use of the bispectral index, near infra-red spectroscopy and monitoring after the administration of neuromuscular blockade. These guidelines apply to all forms of anesthesia administered by an anesthesiologist or anesthesia care team including general anesthesia, regional anesthesia and deep sedation, in both adults and children.
KeywordsAmbulatory surgical center Ambulatory anesthesia Standard monitoring Standard equipment Patient safety
- 1.Becker’s ASC Review. 51 Things To Know About the ASC Industry; 2017. https://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/50-things-to-know-about-the-asc-industry-2017.html.
- 2.VMG H. Multi-Specialty ASC Study; 2017. https://vmghealth.com/wp-content/uploads/2018/01/VMG-Health-Intellimarker-Multi-Specialty-ASC-Study-2017.pdf.
- 3.Committee on Ambulatory Surgical Care. Guidelines for Office-Based Anesthesia; 2014.Google Scholar
- 4.Committee on Ambulatory Surgical Care. Standards for Basic Anesthetic Monitoring; 2014.Google Scholar
- 5.Sub-Committee of ASA Committee on Equipment and Facilities. Recommendations for Pre-Anesthesia Checkout Procedures; 2008.Google Scholar
- 6.World Health Organization, Anesthesia Safety Checklist SS& SA. Gas and Vacuum Supplies.Google Scholar
- 10.Larach MG, Brandom BW, Allen GC, Gronert GA, Lehman EB. Malignant hyperthermia deaths related to inadequate temperature monitoring, 2007-2012: a report from the North American malignant hyperthermia registry of the malignant hyperthermia association of the United States. Anesth Analg. 2014;119(6):1359–66.CrossRefGoogle Scholar
- 15.The APSF Collaborative Panel on Neuromuscular Blockade and Patient Safety. Neuromuscular Blockade and Patient Safety; 2017. https://www.apsf.org/article/presentation-of-the-apsf-collaborative-panel-on-neuromuscular-blockade-and-patient-safety-at-the-2017-asa-annual-meeting/.
- 17.Checketts MR, Alladi R, Ferguson K, Gemmell L, Handy JM, Klein AA, Love NJ, Misra U, Morris C, Nathanson MH, Consultant G, Rodney E, Verma R, Pandit JJ. Recommendations for standards of monitoring during anaesthesia and recovery 2015: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2016;71(1):85–93.CrossRefGoogle Scholar
- 19.Della Rocca G, Pompei L, Pagan DE Paganis C, Tesoro S, Mendola C, Boninsegni P, Tempia A, Manstretta S, Zamidei L, Gratarola A, Murabito P, Fuggiano L, DI Marco P. Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study. Acta Anaesthesiol Scand. 2013;57(9):1138–45.CrossRefGoogle Scholar
- 20.Brueckmann B, Sasaki N, Grobara P, Li MK, Woo T, de Bie J, Maktabi M, Lee J, Kwo J, Pino R, Sabouri AS, McGovern F, Staehr-Rye AK, Eikermann M. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade: a randomized, controlled study. Br J Anaesth. 2015;115(5):743–51.CrossRefGoogle Scholar
- 21.Nielsen H. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery. Front Physiol. 2014;5(93):1–15.Google Scholar
- 22.Picton P, Dering A, Alexander A, Neff M, Miller BS, Shanks A, Housey M, Mashour GA. Influence of ventilation strategies and anesthetic techniques on regional cerebral oximetry in the beach chair position: a prospective interventional study with a randomized comparison of two anesthetics. Anesthesiology. 2015;123(4):765–74.CrossRefGoogle Scholar
- 23.Jeong H, Jeong S, Lim HJ, Lee J, Yoo KY. Cerebral oxygen saturation measured by near-infrared spectroscopy and jugular venous bulb oxygen saturation during arthroscopic shoulder surgery in beach chair position under sevoflurane-nitrous oxide or propofol-remifentanil anesthesia. Anesthesiology. 2012;116(5):1047–56.CrossRefGoogle Scholar