Anesthesiologist

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Within the ambulatory division, practitioners will rotate among the 6 system outpatient sites (Royal Oak/Plymouth/Fairlane/Lakeside/Columbus/Cottage). Cases start at 7 am at most sites with intended off‑table time of 3 pm. Providers stay until the last patient is discharged from PACU. Some sites will require 2 providers depending on the number of rooms/blend of cases that day. Case types are representative of all surgical subspecialities with some sites “specializing” in a more limited number of service lines.

A background in regional anesthesia is a must (neuraxial anesthesia as well as “bread and butter” blocks). Anesthesiologists will also complete online pre‑operative evaluations to determine patient ASC candidacy and/or optimization. Residents rotate commonly at one of the locations and teaching is a component of those days.

• Assessment of consultation for and preparation of patients for anesthesia.
• Medical management of patients and the anesthetic for the planned procedures.
• Post‑anesthetic evaluation and treatment.
• On‑site medical direction of any non‑physician who participates in the delivery of anesthesia care to the patient.
• Perioperative pain management.
• The same standards for and quality of anesthetic care should be available for all patients, emergency as well as elective patients.

• Review the medical records.
• Interview the patient, parents or guardians of a minor, next of kin if patient is unable to communicate, or review the available medical information if no information can be supplied by any of the above to:
  Discuss the medical history, including anesthetic experiences and drug therapy.
• Perform any examinations that would provide information that might assist in decisions regarding anesthetic risk and management.
• Order tests and medications necessary to the conduct of anesthesia.
• Obtain consultations as necessary.
• Record an assessment and an anesthetic plan on the patient’s chart.
• Ensure consent has been obtained.

• Re‑evaluation of the patient immediately prior to induction.
• Prepare and check equipment, drugs, fluids and gas supplies.
• Appropriate monitoring of the patient.
• Selection and administration of anesthetic agents or render the patient insensible to pain, while providing a level of comfort and relaxation commensurate with the invasiveness and physiologic stress of the planned procedure.
• Support of life functions under the stress of anesthetic, surgical and obstetrical manipulations.
• Record the pertinent events of the procedure.

• Give to the health care receiver transfer of care information pertinent to the patient’s specific needs and ensure a safe transition.
• Remain with the patient as long as medically necessary and until the receiving health care provider has all the information needed to assume care.
• Assure the patient is discharged from the postanesthesia care unit in accordance with policies established by the Department of Anesthesiology.
• The duration of surveillance in the postanesthesia care unit is determined by the status of the patient and the judgment of the anesthesiologist.
• Anesthesia Care Team (ACT) – Anesthesiologists supervising resident physicians in training and/or directing qualified non‑physician anesthesia providers in the provision of anesthesia care wherein the physician may delegate monitoring and appropriate tasks while retaining overall responsibility for the patient.
• Preanesthetic evaluation of the patient – Non‑physicians may contribute to the preoperative collection and documentation of patient data, but the anesthesiologist is responsible for the overall evaluation of each patient.
• Prescribing the anesthetic plan – The anesthesiologist is responsible for prescribing an anesthesia plan aimed at the greatest safety and highest quality for each patient. The anesthesiologist discusses with the patient (when appropriate), the anesthetic risks, benefits and alternatives and obtains informed consent. When a portion of the anesthetic care will be performed by another…