Patients

Your anesthesiologist takes several factors into account when recommending the type of anesthesia. Some of those factors include the type of surgery or non-operative procedure being performed and your medical history. These types of anesthesia are not always clearly defined, and patients may progress from one level of sedation/anesthesia to a lighter or deeper level during the procedure. For this reason, the American Society of Anesthesiologists (ASA) considers anesthesia a continuum, from light sedation to general anesthesia.

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“Anesthesia Care Team”
Most anesthetics administered in Pennsylvania are provided using an “Anesthesia Care Team” model, with the anesthesiologist serving as the “director” of the anesthesia care team. Prior to surgery the anesthesiologist evaluates the patients’ current state of health and is responsible for designing the anesthesia plan taking into account the patient’s condition and the nature of the surgery.

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Anesthesiologists

  • Awareness Under Anesthesia (Patient Safety)

    5/8/2012 Intraoperative recall and awareness is a rare, but psychologically significant and devastating phenomenon, with an incidence between 0.1-0.2 percent, translating to approximately 20,000-40,000 patients per year (1,2). Discovering methods for detection and avoidance is critical in prevention of long-term consequences, specifically post-traumatic stress disorder.

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  • The History of Modern Anesthesia

    5/7/2012 As anesthesiologists, CRNAs, hospital administrators, and health policy experts debate and consider scope of practice and supervision issues for non-physician anesthetists, those supporting a broad scope of practice often point out that nurses, not anesthesiologists, were the first modern anesthesia providers. Most of these historical references are accurate. The question is, what is the significance of this history?

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  • Management of Postoperative Nausea and Vomiting

    2/14/2012 Postoperative nausea and vomiting (PONV) is a common problem that affects approximately 30 percent of patients undergoing surgery, but can be as high as 80 percent in high risk patients. PONV is one of the most common reasons for unanticipated admissions after surgery.

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  • Don’t Let Half-Truths Determine Patient Care!

    10/8/2010 The motto of the PSA is “Physicians Protecting Patients.” In addition to the clinical care that anesthesiologists provide daily in the OR, the ICU and the Pain Clinic, we must advocate and provide for patient protection in the legislative arena.

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Physicians

The choice of anesthetic or sedation is made by a physician taking into account various factors, including but not limited to the procedure being performed and the general medical condition of the patient. General anesthesia may be administered by an anesthesiologist, a nurse anesthetist under the direct supervision of a physician, preferably an anesthesiologist, or in some states by an anesthesiologist’s assistant under the direct supervision of an anesthesiologist. 

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The Anesthesiologist’s Expanding Role
The Centers for Medicare and Medicaid Services (CMS) released a January 2011 update to their Interpretive Guidelines for the Anesthesia Services Condition of Participation for Hospitals. As a result anesthesiologists have assumed a leadership role in developing and implementing medical staff rules and regulations (bylaws) that define the qualifications and supervision requirements for many “categories of practitioners”, such as those providers performing “Moderate Sedation”, “Deep Sedation” or obstetrical “analgesia” services. 

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