Day case surgery, also known as ambulatory surgery, refers to surgical procedures that do not require an overnight hospital stay. Key benefits include lower costs compared to inpatient surgery due to reduced testing, medications, and avoiding overnight admission. Patients must be selected carefully based on surgical and medical factors to ensure safe recovery at home within 24 hours. Preoperative assessment identifies risks while preparation educates patients and optimizes their status. Anesthesia techniques aim for rapid recovery and minimal side effects, commonly using propofol or sevoflurane with regional or local anesthesia alternatives. Close monitoring and discharge criteria ensure safe recovery.
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
Surgery Resident clinical seminar on day case surgery presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
Peri-operative Nursing/Anesthesia/Pain ManagementWasim Ak
The care provide during surgical intervention (pre-operative, intra-operative and post-operative period) is known as Peri-operative Nursing Care.
Peri-operative Nursing Care includes :
Pre-operative Nursing Care
Intra-operative Nursing Care
Post-operative Nursing Care.
Anesthesia means “loss of sensation with or without loss of consciousness” .
Medications that cause anaesthesia, are called Anesthetics.
Anesthesia is defined as a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
Anesthesia is defined as a loss of feeling or awareness caused by drugs or other substances which keeps patient free from feeling pain during surgery or other procedures.
Professor Panditrao expresses his views about the day to day challenge, faced in clinical practice. Considered to be a simple surgery, but the anesthetic management is very challenging because of the primary pathology, co-morbidities and repeated surgeries involved.
Dr. Kenneth Dickie from Royal Centre of Plastic Surgery in Barrie, Ontario explained the refining experience for Ambulatory Surgery.
If you have any questions, please contact Dr. Kenneth Dickie at http://royalcentreofplasticsurgery.com/
Surgery Resident clinical seminar on day case surgery presented to the department of surgery, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
Peri-operative Nursing/Anesthesia/Pain ManagementWasim Ak
The care provide during surgical intervention (pre-operative, intra-operative and post-operative period) is known as Peri-operative Nursing Care.
Peri-operative Nursing Care includes :
Pre-operative Nursing Care
Intra-operative Nursing Care
Post-operative Nursing Care.
Anesthesia means “loss of sensation with or without loss of consciousness” .
Medications that cause anaesthesia, are called Anesthetics.
Anesthesia is defined as a temporary state consisting of unconsciousness, loss of memory, lack of pain, and muscle relaxation.
Anesthesia is defined as a loss of feeling or awareness caused by drugs or other substances which keeps patient free from feeling pain during surgery or other procedures.
Professor Panditrao expresses his views about the day to day challenge, faced in clinical practice. Considered to be a simple surgery, but the anesthetic management is very challenging because of the primary pathology, co-morbidities and repeated surgeries involved.
Dr. Kenneth Dickie from Royal Centre of Plastic Surgery in Barrie, Ontario explained the refining experience for Ambulatory Surgery.
If you have any questions, please contact Dr. Kenneth Dickie at http://royalcentreofplasticsurgery.com/
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Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
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Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
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Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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2. Lay Out
• Defintion
• History
• Benefits
• Patient selection criteria
• Preoperative assessment
• Patient preparation
• Anesthesia Techniques
• Recovery from Ambulatory surgery
• Home Readiness and Beyond
3. Definition
A surgical day case is a patient who is:
• admitted for investigation or operation on a planned non-
resident basis and
• who non the less requires facilities for recovery.
• The procedure should not require a over night stay in
hospital bed.
4. History
• James Hendersin Nicoll, perforned 9000 surgeries b/w
1898-1908
• Ralph Milton Waters
• 1st hospital based ambulatory surgical units were opened
in 1951 and 1952.
• Ambulatory as a recognized subspeciality was enhanced
by formation of SAMBA in 1984 and british association
day surgery in 1989
• Above 2 and 9 other societies now form an ubrella
organization, IAAS (International association for
ambulatory surgery)
5. Benefits of Day Case Surgery
• Significant reduction in medical costs(d/t overnight
admission, less pre-operative testing and postoperative
medication)
• Increased availability of indoor beds
• Comfort & Convenience of recovering in the familiar home
environment.(particularly in children, it reduces the
separation-induced anxiety problems)
6. Models of Day Case Surgeries
• Hospital integrated
• Hospital self-contained
• Free standing
• Office based
7. Patient Selection Criteria
• Surgical factors:
• The extent of surgical trauma- more significant
determinant
• Duration of surgery
• No expectation of significant blood loss, large peri-
operative fluid shifts, or the need for complex or
specialized postoperative care.
• Postop pain
• Conservative minset of some surgeons
8. Patient Selection Criteria (Cont...)
• Medical Factors:
• Obstructive Sleep Apnea
• Age
• Cardiovascular diseases
9. Patient Selection Criteria: (Cont...)
• Social factors:
• Access to a telephone/mobile to summon assistance
• Travelling distance
• Discharge with a responsible adult escort and
recommendation to have a to stay with the for next 24 hrs
10. Preoperative Assessment
• 4 major roles of preoperative assessment:
• Identify absolute contraindications to ambulatory surgery
• Identify need for optimization
• Highlight issues for anesthesiologist or other staffs
• Provide patient information
11. Pre-operative Assessment (Cont...)
• Mechanisms and timing of preop assessment:
• One stop shop (Preop assessment immediately follows
surgical consultation)
• Basic screening Tool
• Telephonic assessment (with clinic attendance required
only if unexpected problems uncovered or if requested by
the patient)
12. Pre-operative Assessment (Cont...)
• Preoperative invesgations:
• History and physical examination reamin the key element.
• Routine lab investigation are unhelpful .
• Only selective testing based on pts clinical evaluation and
demographics
• Patient age no longer be advocated as routine preop
testing
13. Patient Preparation
Provision of information
Preop Fasting
Pre-medication:
• Management of Anxiety
• Anxiolytic premedication
• Analgesic Premedication
• Prophyolactic premedication
• Antacids and gastrokinetic medications
14. Anestrhesia Techniques
• Choice of technique:
• Appropriate and controllable intraoperative conditions
• Rapid recovery
• Minimal side effects
• Pompt return to normal psychyomotor activity
15. Anesthesia Techniques
GENERAL ANESTHESIA:
Intravenous Anesthesia:
• Propofol-most practical iv agent for ambulatory surgery
• Why it is ideal choice?
• Rapid and smooth induction without airway irritation and
results in rapid recovery and infrequent PONV
• How the adverse effects can be reduced?
• Pain on injection
• Hypotension
• Induction with Midazolam, Fentanyl, auto-coinduction
16. Anesthesia Techniques
• Inhaled Anesthetics:
• Most popular choice for maintenace of ambulatory surgery
• Sevoflurane:
• Low-solubility and minimal airway irritation makes it easily
controllable & short acting anestheteic for these surgeries
• Orietation occured earlier than propofol, but time to home
readiness is similar (15 min for both, 25 min faster than with
isoflurane)
• How to reduce the adverse events?
• PONV , Emergence delirium in children
