Frequency and implications of ambulatory surgery without a patient escort

Chung, Frances; Imasogie, Ngozi; Ho, Joyce; Ning, Xiangqun; Prabhu, Atul; Curti, Bruna

doi:10.1007/bf03021599

Cited by 17 publications

(8 citation statements)

References 14 publications

(10 reference statements)

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“… 17 Friedman et al found that 11% of Canadian Society of Anesthesiologists in a 2004 survey stated that they would feel comfortable anesthetizing unescorted patients for outpatient procedures. 18 A year later, Chung et al 19 relayed that 0.2% of patients arriving at a tertiary care institution for outpatient surgery over a 38-month period had no escort. Most of these patients underwent surgery, left without an escort, and suffered no increase in measured postdischarge complications compared with patients discharged with an escort.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Dismissal With a Responsible Adult Compared With Structured Solo Dismissal: A Retrospective Case-Control Comparison of Safety Outcomes

Martin

Warner

Johnson

et al. 2018

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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ObjectiveTo test the hypothesis that patients dismissed alone in a sedation dismissal process (SDP) have no greater risk of adverse outcome compared with those who were dismissed with a responsible adult.Patients and MethodsWe compared 2441 SDP patients undergoing 2703 procedures with 4923 unique control patients who underwent 5133 procedures between June 1, 2012, and March 31, 2017.ResultsThe rate of unplanned readmission related to the procedure was 0.11% (n=9), and there was no difference between SDP (0.07%) and controls (0.14%). Similarly, there was no difference in complication rates between SDP patients and controls when restricting to “all causes” unplanned readmissions within 24 hours and unplanned readmissions related to procedure.ConclusionWith proper preparation, short-acting anesthetic/sedation medications, and sound clinical judgment, the presence of a responsible adult escort is not associated with reduced risk following discharge after ambulatory anesthesia. This practice may lessen the hardships reported by patients in needing to obtain an escort and the inconveniences and delays experienced by ambulatory procedural facilities when patients arrive without a designated escort.

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Section: Discussionmentioning

confidence: 99%

Outpatient Dismissal With a Responsible Adult Compared With Structured Solo Dismissal: A Retrospective Case-Control Comparison of Safety Outcomes

Martin

Warner

Johnson

et al. 2018

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…A study in our institution showed that 0.2% of patients presented without an escort on the day of the procedure. 8 Two groups of patients were identified. The first group (n ϭ 24) was comprised of patients who had no escort.…”

Section: Discussionmentioning

confidence: 99%

“…8 Another survey indicated that 11% of anesthesiologists would be willing to anesthetize patients without an escort. 9 The Canadian Medical Protective Association (CMPA) is a mutual defense organization for physicians who practice in Canada.…”

mentioning

confidence: 99%

Car Accidents After Ambulatory Surgery in Patients Without an Escort

Chung

Assmann

2008

Anesthesia &Amp; Analgesia

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Occasionally, ambulatory surgical patients present without an escort for their procedure. This creates a dilemma for caregivers, and allowing patients to drive may have an impact on their safety. The Canadian Medical Protective Association is a mutual defense organization for 95% of Canadian physicians. The national database is a unique and extensive repository of medico-legal data. We scanned this database for malpractice patients who were discharged after an ambulatory surgery procedure and allowed to drive home with a poor outcome. From this database, two malpractice cases of patients who were discharged without an escort after an ambulatory surgical procedure were reported. Both had a car accident and sustained serious injuries. Based on this we do not recommend discharge without an escort after general anesthesia, regional anesthesia, monitored anesthesia or sedation. Driving after ambulatory surgery cannot be considered safe and caregivers need to verify a safe ride home.

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“…Es importante señalar que el trasladado desde recuperación fase I y el alta desde la fase II debe ser evaluado y autorizado por un médico, habitualmente un anestesista. Finalmente, para dar de alta a un paciente son obligatorios los siguientes requisitos 14,15 No cumplir con alguno de estos requisitos implica que el paciente se debe quedar hospitalizado la primera noche posoperatoria.…”

Section: Recuperación Fase II O Prealtaunclassified

Cirugía ambulatoria: ¿Qué hacer en el período posoperatorio? Desde el término de la cirugía hasta el control domiciliario

et al. 2018

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Postoperative recovery and post discharge surveillance and support are essential in outpatient surgery success. The postoperative recovery process is divided into Phase I and Phase II, in which predefined clinical criteria are used to decide whether a patient can be moved to the next phase or be discharged to home, respectively. At discharge, postoperative indications are given in writing and an adult must accompany the patient. After discharge, the patient is monitored during the first few days, usually through a telephone call and predefined clinical parameters are evaluated. Outpatient surgery outcome evaluation is performed through specific indicators such as prolonged postoperative stay, unanticipated hospital admission, and return to hospital and readmission.

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Frequency and implications of ambulatory surgery without a patient escort

Cited by 17 publications

References 14 publications

Outpatient Dismissal With a Responsible Adult Compared With Structured Solo Dismissal: A Retrospective Case-Control Comparison of Safety Outcomes

Outpatient Dismissal With a Responsible Adult Compared With Structured Solo Dismissal: A Retrospective Case-Control Comparison of Safety Outcomes

Car Accidents After Ambulatory Surgery in Patients Without an Escort

Cirugía ambulatoria: ¿Qué hacer en el período posoperatorio? Desde el término de la cirugía hasta el control domiciliario

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