PLANNING,

DESIGNING,
FUNCTIONS &
MANAGEMENT
OF
ANESTHESIA
DEPARTMENT

Phenahas Sathyavrithan
AHS19BHAD002
AIAHS – BHA – SEMESTER 3
WHAT IS ANESTHESIA ?
o Anesthesia is the practice of medicine dealing with :

a. the administration of medication to produce a blunting or loss of pain perception, voluntary and
involuntary muscle movements, autonomic function and memory or consciousness

b. the support of a patient’s life functions under the stress of anesthetic and surgical manipulations;

c. the management of patients and problems related to the relief of pain;

d. the management of patients and problems during cardiac and respiratory resuscitation and

e. clinical management of patients with various fluid, electrolyte and metabolic disturbances.
o Analgesia/Sedation involves the use of a medication to provide relief of pain through
the blocking of pain receptors in the peripheral and/or central nervous system

o The patient does not lose consciousness, but does not perceive pain to the extent that may
otherwise prevail
FUNCTIONS OF ANESTHESIA DEPARTMENT
A hospital's anesthesia department plays a key role in many areas of the facility's operations including
operating room efficiency, patient safety and clinical outcomes and patient, surgeon
and surgical staff satisfaction

• All services along the continuum of anesthesia care provided in the hospital are organized under the Anesthesia
Department, which are directed by the Anesthesia Department Chair

• Consistently implemented in every department and setting that provides any type of anesthesia services

• The Anesthesia Department is responsible for participating in the development of policies and procedures

Cont..
• The Anesthesia Department will be responsible to monitor and evaluate the quality and appropriateness
of anesthesia patient care

• Replacement of Anesthesia and related equipment

• Anesthesia Staff members works with Surgical services, Administration and Other departments,
as appropriate, to establish par level, and promote cost-effective use of
anesthesia equipment

• The Anesthesia Department should provide guidelines for the Type and Amount of coverage provided

• Pre-anesthesia evaluation will be performed

Cont..
• Orientation for anesthesia personnel

• Departmental Orientation will include :

a. Review of the Anesthesia Department Policy & Procedures Manual.

b. Tour of the physical locations of the different departments utilizing anesthesia services, including the
Operating Suites, Emergency Room, Radiology, Intensive Care, Obstetrical Suites, Cardiac Catheterization
Lab, etc.
c. Familiarization with the location of drugs, equipment and supplies.
d. Instructions on:
i. Proper blood sample drawing, labeling and specimen dispatch to appropriate labs
ii. Controlled substance procurement and documentation
iii. Information system training
e. Documentation requirements for anesthetic patient care.
f. Government medical legal compliance procedures and documentation.

• To provide for the general rules of conduct for the Anesthesia staff

Cont..
• The Anesthesiology Department is responsible for providing all Anesthesia and Pain management
services

• General and regional anesthesia in operating suites, obstetrics, emergency room, radiology
and intensive care

• Anesthesia services is available twenty-four (24) hours of the day and night for emergency cases
ORGANIZATION
OF
THE
ANESTHESIA
DEPARTMENT
Outlines the structure and manner in which
the Anesthesia Department is organized
FUNCTIONS OF OFFICERS -
A. CHAIR

The Chair of the Anesthesiology Department shall be responsible for the direction of all anesthesia
services in the hospital as well as the overall supervision of clinical work
in the department. He/She also shall be responsible for:

• Planning, directing, and supervising all activities of

anesthesia services throughout the hospital. This includes
reviewing and granting requests for Anesthesia privileges
throughout the hospital.

• Evaluating the quality and appropriateness of the

anesthesia services provided to patients as
part of the hospital’s Performance Improvement Program.
This includes tracking compliance of defined quality measures and
reviewing individual cases and automatic rule violations as
identified by the hospital’s Multidisciplinary Peer Review Committee .
 • Recommendations to administration and medical staff for new equipment

• Continuing medical education of the Anesthesiology Department

• Enforcement of the Anesthesia Committee Guidelines, Rules and Regulations

• Presiding over Anesthesia Committee and Department meetings

• Serving on the Executive Committee of the Medical Staff

B. CHAIR-ELECT
• The Chair-Elect shall assume the responsibilities of the Chair in the event of the Chair’s absence.
After the Chair’s term of office expires, the Chair-Elect shall succeed him/her

C. OB/ANESTHESIA SERVICES DIRECTOR

• The OB/Anesthesia Services Director shall coordinate, supervise and evaluate OB anesthesia services
and assist with planning, development and implementation of new services under the direction of the
Chair of the Anesthesiology Department. The OB Director will assist in efforts to develop advanced
competencies for staff of OB Anesthesia and review and recommend clinical policies applicable to OB Anesthesia
D. EDUCATION DIRECTOR
• The Education Director shall be responsible for developing and producing a medical education
program. The program shall be directed toward the continuing education of the Anesthesiologists, the
nurse anesthetists and the recovery room nurses
Design of Anesthesia in a Operating room
PLANNING OF ANESTHESIA DEPARTMENT

Pre- Review of Intra- Post- Post-

Anesthesia Equipment Operative Anesthesia Anesthesia
Evaluation Anesthesia Recovery Care
Care Room

1 2 3 4 5
1. Pre-Anesthesia Evaluation

• Prior to performing any anesthetic, anesthesiologist must perform a pre-anesthesia evaluation

• pre-anesthesia evaluation must be performed within 48 hours prior to surgery

• pre-anesthesia evaluation must be performed for each patient who receives general, regional,
or monitored anesthesia care

• pre-anesthesia evaluation must be completed and documented within 48 hours

immediately prior to any inpatient or outpatient surgery or procedure requiring anesthesia services

• The pre-anesthesia evaluation of the patient includes :

1. Review of the medical history, including anesthesia, drug and allergy history; and
 2. Interview, if possible given the patient’s condition, and examination of the patient

3. Notation of anesthesia risk

4. Identification of potential anesthesia problems, particularly those that may suggest potential
complications to the planned procedure

5. Additional pre-anesthesia data or information, if applicable and as required in accordance with

standard practice prior to administering anesthesia

6. Development of the plan for the patient’s anesthesia care and discussion with the patient of the risks
and benefits of the delivery of anesthesia

• Surgeons may request a certain anesthesia type but the authority of the final anesthesia plan is at the
medical discretion of the anesthesia provider
2. Review of Equipment

• Prior to induction of anesthesia, the anesthesia provider shall check the working condition, safety,
cleanliness, and availability of necessary anesthetic equipment and agents following

3. Intra-Operative Anesthesia Care

• Patient shall be continuously and vigilantly monitored

• An anesthesia record shall be fully completed for each case, which shall include the recording of all
pertinent events taking place and maintenance of anesthesia, including the dosage and duration of all
anesthetic agents, other drugs, intravenous fluids, intra operative lab values ,blood or blood components,
4. Post-Anesthesia Recovery Room

• The patient is turned over to Recovery Room personnel for care when his/her condition is deemed safe for
doing so by the anesthesia provider

• The patient is discharged from the Recovery Room when he/she meets criteria under the standing
Recovery Room Orders.

5. Post-Anesthesia Care

• General Accepted standards of anesthesia care indicate that the evaluation should not begin until the patient is
sufficiently recovered from the acute administration of the anesthesia so as to participate in the
evaluation, example; answer questions appropriately, perform simple tasks, etc .
• The elements of an adequate post-anesthesia evaluation should be clearly documented and
conform to current standards of anesthesia care, including:

1. Respiratory function, including respiratory rate, airway patency, and oxygen saturation

2. Cardiovascular function, including pulse rate and blood pressure

3. Mental status

4. Temperature

5. Pain

6. Nausea and vomiting; and

7. Postoperative hydration.
QUESTIONS ?