Thursday, February 28, 2019

The Uber Driver and an outpatient surgery center patient. Hear Ye, Hear Ye!

Before you go and get all up in excitment for all those patients that got cancelled because they had no one to drive them home, I throw a wrench or two into your irrational thinking.

First of all, let us divide the patients that undergo local anesthesia procedures versus the ones that have IV Sedation and up to General Anesthesia.  For the clarification, patients that undergo local anesthesia only, these patients DO NOT need to be driven home or have an adult remain with them for 24hours post op.

Now, let's talk sedation and all the things in between it and general anesthesia.  Foremost, the definition of how the state of California defines what can and cannot be done in an outpatient surgery center that does not possess accreditation or Medicare Certification is this, "Anytime a medical procedure is performed under anesthesia that places patients at risk of losing their life-preserving protective reflexes, the medical procedure must be done in a licensed, certified, or accredited setting."

Now let us look at the accreditation standards for anesthesia and going home alone and or driving themselves home postop.  The consistency between all accrediting firms is that if the patient receives any sedation at all, anything other than local anesthesia, then the patient must be driven home and not allowed to drive themselves.  Point #1.

Any patient that receives anesthesia considered deep sedation, mac, or general, and all the ones in between, these patients should not be allowed to be home alone for the first 24 hours.  Point #2.

Either one of these rules in accreditation standards requires that there be an order from the physician that orders and allows the deviation from the standard by showing the physician physically assessed them and finds them to be stable and resolved of any side effects from the anesthesia to where they can either drive themselves and/or supervise themselves postop the first 24 hours.

It would be feasible to assume that the Governing Body would and could make it part of the facility policy that local cases can drive, uber, be driven by friend, any of the above.  While they also could be alone the first 24 hours.  Everything other than local, then this should be a case by case situation depending on the patient, their living situation, their age, their cognitive abilities, etc. postop.

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