Social

Social

Social criteria for day surgery include: /uni25CF Adequate housing conditions such as heating, an inside toilet and access to a phone. /uni25CF The patient should live within a 1-hour drive of a hospital. /uni25CF A responsible adult should be able to stay with the patient for 24 hours after a regional anaesthetic/general anaesthetic. The first two points are generally achievable as the patient needs to be 1 hour from ‘a hospital’ that can treat them rather than the hospital where surgery was performed. With respect to the r esponsible adult, there have been two solutions introduced for this by centres in the UK: 1 The Torbay and South Devon NHS Foundation Trust model provides carers into the patient’s home. 2 Norfolk and Norwich University Hospital model allows some patients home without carers after certain proce dures ( Figure 22.3 ). Both pathways have been in place for a number of years with excellent patient satisfaction and no adverse outcomes.

Red /f_l ags • Poor functional capacity • Abnormal ECG • Uncontrolled BP , CCF or IHD • S O <94% on air p 2 • If bicarbonate >27, OHS likely • Previous DVT/PE • STOP-BANG ≥5 • OS-MRS >3 • Metabolic syndrome • High ACS NSQIP risk Figure 22.2 Society of Bariatric Anaesthesia (SOBA) red /f_l ags. BP , blood pressure; CCF , congestive cardiac failure; CPAP , continuous positive airway pressure; DVT, deep vein thrombosis; ECG, electrocardiogram; HDU, high-dependency unit; IHD, ischaemic heart disease; ACS NSQIP , American College of Surgeons National Surgical Quality Improvement Program; OHS, obesity hypoventilation syndrome; OS-MRS, obesity surgery mortality risk score; PE, pulmonary embolism; S O , oxygen saturation; STOP-BANG, Snoring ,Tiredness, Observed apnoeas, Pressure p 2 (hypertensive), Body mass index, Age, Neck circumference, Gender.

Social

Social criteria for day surgery include: /uni25CF Adequate housing conditions such as heating, an inside toilet and access to a phone. /uni25CF The patient should live within a 1-hour drive of a hospital. /uni25CF A responsible adult should be able to stay with the patient for 24 hours after a regional anaesthetic/general anaesthetic. The first two points are generally achievable as the patient needs to be 1 hour from ‘a hospital’ that can treat them rather than the hospital where surgery was performed. With respect to the r esponsible adult, there have been two solutions introduced for this by centres in the UK: 1 The Torbay and South Devon NHS Foundation Trust model provides carers into the patient’s home. 2 Norfolk and Norwich University Hospital model allows some patients home without carers after certain proce dures ( Figure 22.3 ). Both pathways have been in place for a number of years with excellent patient satisfaction and no adverse outcomes.

Red /f_l ags • Poor functional capacity • Abnormal ECG • Uncontrolled BP , CCF or IHD • S O <94% on air p 2 • If bicarbonate >27, OHS likely • Previous DVT/PE • STOP-BANG ≥5 • OS-MRS >3 • Metabolic syndrome • High ACS NSQIP risk Figure 22.2 Society of Bariatric Anaesthesia (SOBA) red /f_l ags. BP , blood pressure; CCF , congestive cardiac failure; CPAP , continuous positive airway pressure; DVT, deep vein thrombosis; ECG, electrocardiogram; HDU, high-dependency unit; IHD, ischaemic heart disease; ACS NSQIP , American College of Surgeons National Surgical Quality Improvement Program; OHS, obesity hypoventilation syndrome; OS-MRS, obesity surgery mortality risk score; PE, pulmonary embolism; S O , oxygen saturation; STOP-BANG, Snoring ,Tiredness, Observed apnoeas, Pressure p 2 (hypertensive), Body mass index, Age, Neck circumference, Gender.

Social

Social criteria for day surgery include: /uni25CF Adequate housing conditions such as heating, an inside toilet and access to a phone. /uni25CF The patient should live within a 1-hour drive of a hospital. /uni25CF A responsible adult should be able to stay with the patient for 24 hours after a regional anaesthetic/general anaesthetic. The first two points are generally achievable as the patient needs to be 1 hour from ‘a hospital’ that can treat them rather than the hospital where surgery was performed. With respect to the r esponsible adult, there have been two solutions introduced for this by centres in the UK: 1 The Torbay and South Devon NHS Foundation Trust model provides carers into the patient’s home. 2 Norfolk and Norwich University Hospital model allows some patients home without carers after certain proce dures ( Figure 22.3 ). Both pathways have been in place for a number of years with excellent patient satisfaction and no adverse outcomes.

Red /f_l ags • Poor functional capacity • Abnormal ECG • Uncontrolled BP , CCF or IHD • S O <94% on air p 2 • If bicarbonate >27, OHS likely • Previous DVT/PE • STOP-BANG ≥5 • OS-MRS >3 • Metabolic syndrome • High ACS NSQIP risk Figure 22.2 Society of Bariatric Anaesthesia (SOBA) red /f_l ags. BP , blood pressure; CCF , congestive cardiac failure; CPAP , continuous positive airway pressure; DVT, deep vein thrombosis; ECG, electrocardiogram; HDU, high-dependency unit; IHD, ischaemic heart disease; ACS NSQIP , American College of Surgeons National Surgical Quality Improvement Program; OHS, obesity hypoventilation syndrome; OS-MRS, obesity surgery mortality risk score; PE, pulmonary embolism; S O , oxygen saturation; STOP-BANG, Snoring ,Tiredness, Observed apnoeas, Pressure p 2 (hypertensive), Body mass index, Age, Neck circumference, Gender.