Medicolegal Issues in Day Care/Ambulatory Surgery

Abstract

Day surgery is the technique of choice for treatment of many clinical conditions in today’s time. The numbers of surgery done as day care are only increasing every day. The world is shifting to a day care format where 23 h seems to be the goal. The obvious advantage would appear to be a reduction in the risk of acquiring hospital-related infections and having complications after the surgery, however, it has its own challenges during the post-operative period. Meticulous care must be taken to ensure that the patient is genuinely fit for day care surgery and if so, fit for discharge after the procedure. Documentation at all levels, along with clear, legible communication, form the cornerstone of avoiding medicolegal issues in an ambulatory or day care setting. Almost all the responsibility of the centre falls on the anaesthetist in charge. It isn’t surprising to see most day care centres being led by anaesthesiologists worldwide.

Annexures

18.1.1 Annexure 1: Pre Operative Check List

Abhishek Day Care Health Service Pvt. Ltd.
O.T. pre operative check list
Name:
IPD no:	Bed no:	Sex:	Age:
Weight:
Surgery:
Attributes	Yes	No	NA
Consent for surgery and anaesthesia
BP
Temp
Pre existing condition—DM, HTN, BA, thyroid
Shaving
Voided urine
Enema
Pre Op medication
Nail polish removed
Jewelery removed
Identification of site
BT/CT/allergies
Dentures/metal fillings
Contact lenses/glasses
CBC
Blood sugar
G6PD
HIV
HBsAg
HCV
Urine
ECG/2D echo
X ray chest
Medical fitness
Accompanying relative
Approved by
Anaesthetist	Surgeon	OT Incharge

18.1.2 Annexure 2, 3, 4 and 5: (In Our Case It Is A Booklet) Informed Consent, Anaesthesia Record, Intraop Monitoring and OT Notes and Post Op/Recovery Record and Materials Used