Patients are increasingly turning to Ambulatory Surgical Centers (or ASCs) for surgical procedures performed outside of the traditional hospital setting. There are several benefits to ASCs. They are generally less expensive than hospital surgery’s, permit patients to go home the same day of surgery, and are often more luxurious than hospital. Today, 65% of all surgeries are now outpatient making ASCs a popular alternative to hospital surgeries. However, ASCs do have some drawbacks. One significant shortcoming to ASC is their ability to manage serious anesthesia errors and complications which are generally more dangerous outside of a hospital.
With virtually all same-day surgery procedures, the most significant risk is from the anesthesia. Although there are many forms of anesthesia, general anesthesia poses the greatest risk of serious injury or wrongful death. Indeed, most medical malpractice lawsuits stemming from anesthesia error involve general anesthesia. Common general anesthesia complications are from aspiration, changes in vital signs, and adverse reactions to anesthetic.
Regarding adverse anesthetic reactions, the most significant and potentially fatal condition that can develop is called malignant hyperthermia (or MH). This occurs when a patient’s body temperature rapidly increases and causes muscle rigidity. With proper management, many patients will experience a full recovery. Without proper management, patients can and do die from MH.
An expert panel from Penn State College of Medicine recommends that all ASCs develop policies for managing malignant hyperthermia. One key guideline recommended by the panel is that ASCs develop plans for immediately transferring patients who experience MH to a nearby hospital for more advanced care. According to the report, MH patients must be immediately transferred to a hospital that is equipped to provide critical care crisis management. After all, most ASCs do not have the ability to manage potentially life threatening anesthesia complications like MH. The panel also recommends that ASCs implement guidelines on giving immediate muscle relaxant medication to MH patients before transfer. After all, for every 30 minutes of delayed muscle relaxant medication to patient with MH, the risk of serious complication doubles.
Although relatively rare, anesthesia complication can be very serious if not fatal. Consequently, any patient with a history of anesthesia complications or who is otherwise at increased risk of anesthesia complication should strongly consider having any surgery involving anesthesia at a hospital rather than an ASC. Indeed, any patient considering surgery that involves general anesthesia should do their homework before blindly agreeing to have their surgery performed at an ASC. Although many ASC have excellent medical staff, few can handle major anesthesia complications as well as competent hospital.
Medical News Today Website, Guidelines For Managing Rare Anesthesia Complication At Ambulatory Surgical Center, January 3, 2012.
Wikipedia, Outpatient Surgery, January 3, 2012.
WebMd, Anesthesia Risks And Complications, January 3, 2012.