Patient Care

Before Anesthesia | After Anesthesia | Types of Anesthesia | Preoperative Interview | Your Medication


CRNA's: A Tradition of Quality Care
CRNA's are anesthesia specialists who administer more than half of the 26 million anesthetics given to patients in the United States each year. Nurse anesthetists represent a long-standing commitment to high standards in a demanding field. Prior to entering the Master's Degree nurse anesthesia educational program. they must have at least one year's acute care experience. Moreover, mandatory continuing education is required for re certification every two years.

Nurse anesthetists provide high quality anesthesia services combined with personal concern for the health and welfare of patients. they are happy to assist you and offer information about what to expect with your anesthesia.

BEFORE ANESTHESIA: Your Active Role Makes a Difference
Anesthesia is a major part of your surgery. During the procedure, anesthesia allows you to be free of pain. All anesthesia care is provided with the highest degree of professionalism, including constant monitoring of every important body function. As changes occur in your reactions to anesthesia, the nurse anesthetist responds with modifications of the anesthetic to ensure your safety and comfort.

In addition to their role in the procedure itself, nurse anesthetists make many preparations for you before surgery. You can -- and should -- take an active role in these preparations by communicating and cooperating with your nurse anesthetist and your surgeon.

There are several kinds of anesthesia.
The anesthetic chosen for you is based on factors such as your physical condition, the nature of the surgery, and your reactions to medications. Frank and open discussion with your nurse anesthetist is key in the selection of the best anesthetic for you.

In particular, you must speak freely and follow instructions closely regarding your intake of medications, food, or beverages before anesthesia. Such substances can react negatively with anesthetic drugs and chemicals.

The preoperative interview is essential to effective communication.
This confidential discussion with the nurse anesthetist prior to surgery or other procedure, provides information vital to your care. In some offices a questionnaire may be provided for you to fill out. This information will assist your nurse anesthetist in determining the appropriate anesthetic for your particular case.
IN ALL CASES THE PATIENT MUST CALL THE ANESTHETIST PRIOR TO THE PROCEDURE.

In addition, preparations should be made before ambulatory surgery for another adult to accompany you to the health care facility, drive you home, and monitor your recovery.

Remember:
Speak frankly. Ask questions. Follow instructions. Provide your nurse anesthetist with a medical history. Notify your nurse anesthetist and doctor immediately of any change in your physical condition prior to surgery. Communication and cooperation are essential to the anesthesia process.

BEFORE ANESTHESIA GUIDELINES

  1. Arrange for a responsible adult to drive you home.
  2. Wear loose, comfortable clothing with short sleeves.
  3. INTAKE OF FOOD OR DRINKS
    A.) MORNING SURGERY:
    DO NOT eat or drink anything PAST MIDNIGHT on the night prior to surgery, except for medication as described below.

    B.) AFTERNOON SURGERY:
    You may eat a light breakfast (coffee, juice, toast). AVOID milk and dairy products as well as greasy foods such as bacon, etc. This breakfast must be eaten at least SIX HOURS PRIOR to your arrival time at the office.

  4. MEDICATIONS
    If you take medications for your heart or blood pressure every morning, PLEASE TAKE THEM the morning of surgery with a small sip of water. If you take insulin, please discuss this with your nurse anesthetist when she calls. If the doctor orders antibiotics prior to surgery, please take them as prescribed. If you take any other medication on a regular basis, please discuss this with the anesthetist when she calls.
  5. PREGNANCY TEST (Dental Patients Only)
    Please perform a home pregnancy test if you think there is a possibility that you may be pregnant. This is to protect the developing embryo from any effect the medication may have.
  6. PLEASE CALL THE NURSE ANESTHETIST AS SOON AS YOU HAVE FINALIZED THE APPOINTMENT.

AFTER ANESTHESIA : Your Active Role Assists Your Recovery

Anesthesia means freedom from pain during surgery. All anesthesia care is provided with the highest degree of professionalism. Sensitive and sophisticated equipment monitors every important function of your body. In response to your body's reactions, the nurse anesthetist modifies your anesthetic as needed.

The medications that you have been given can remain in your body for up to 24 hours after their administration. You are not completely "back to your old self" until the anesthetic has been totally eliminated.

Also during this time, it is still possible for substances entering your body to interact with the anesthetic. Certain substances may cause negative reactions. Therefore, check with your care provider about what medications you can take. Continue to cooperate with your nurse anesthetist and physician after surgery. Don't hesitate to ask questions.

"Don'ts" After Anesthesia

After receiving anesthesia during a surgical procedure, you can play an active role in your recovery by adhering the straightforward list of do's and don'ts that follows.
  • Don't drive a car for at least 24 hours. After anesthesia, your reactions and judgment may be impaired. Such impairment makes driving a car dangerous to you and to others. It is especially important that you don't forget to make arrangements for someone else to drive you home from the health care facility.
  • Don't operate complex equipment for at least 24 hours. The same logic that applies to driving a car similarly applies to the operation of other equipment. This includes equipment used at home, such as a lawn mower, as well as that which is used on the job, such as a forklift truck.
  • Don't make any important decisions or sign any legal documents for the day. The potential for impairment relates not only to physical activities but to your mental state also. Moreover, the anxiety that frequently accompanies important decisions is to be avoided. The day should be spent resting.
  • Don't study for exams. After anesthesia you may not remember the information.
  • Don't take any medications unless prescribed by or discussed with your physician. Some medications may adversely interact with anesthetic drugs or chemicals remaining in your body. Included are prescription drugs, such as sleeping pills or tranquilizers, and over-the-counter medications, such as aspirin.
  • Don't drink alcohol for at least 24 hours. Alcohol is also considered a drug, meaning that an alcoholic drink has the potential to negatively react with the anesthetic in your system. This includes hard liquor, beer, and wine.
  • Don't drive a car for at least 24 hours.
  • Don't operate complex equipment for at least 24 hours.
  • Don't make any important decisions or sign any legal documents for the day.
  • Don't take any medications unless prescribed by or discussed with your physician.
  • Don't drink alcohol for at least 24 hours.

"Do's" After Anesthesia

  • Do leave the health care facility accompanied by a responsible adult. This person will ensure that you travel home safely, as well as provide immediate care at home. You should continue to have this adult with you for 24 hours after surgery.
  • Do remain quietly at home for the day and rest. You need rest because you have received anesthesia and because you have undergone a procedure -- even one that is considered minor. If, after a day, you still do not feel recovered, you may want to continue your rest for an additional day or two. Discuss your planned return to work with your physician.
  • Do arrange for someone to care for your small children for the day. Even if given instructions to play peacefully and not overtax you, children sometimes forget such directions or have trouble staying quiet for an entire day.
  • Do take liquids first and slowly progress to a light meal. Heavy foods can be difficult for your system to digest, thereby increasing the chance for discomfort. For your nourishment, start by taking liquids, then eat light foods, such as broth or soup, crackers or toast, plain rice, Jell-O, and yogurt.
  • Do call your nurse anesthetist, your physician, or the facility where you were treated if you have any questions. These professionals are interested in your welfare and want your care to go as planned. If you have questions, or feel your recovery is not progressing to your satisfaction, call them.
  • Do leave the health care facility accompanied by a responsible adult.
  • Do remain quietly at home for the day and rest.
  • Do arrange for someone to care of your small children for the day.
  • Do take liquids first and slowly progress to a light meal.
  • Do call your nurse anesthetist, your physician, or the facility where you were treated if you have any questions.

Remember:
Communication and cooperation are essential to the anesthesia process. Active participation in your care helps ensure your safety and comfort.

POST ANESTHESIA GUIDELINES

  1. Arrange for a responsible adult to care for you the day of and the night following your procedure.
  2. The person caring for an individual post Intravenous Sedation must be alert to the possibilities of over sedation, drowsiness, unsteady gait, low blood sugar, faulty reasoning and decision making in the patient. The caregiver must check on the patient every 10-15 minutes for approximately two hours. During this time the patient needs assistance in usual, routine activities. Medications should be noted on a pad of paper as to the time and amount taken. Talking on the phone is usually not a good idea after sedation.
  3. Do not make any major decisions for 24 hours following anesthesia.
  4. Do not drive a car for 24 hours following anesthesia.
  5. Do not take medications unless prescribed by or approved of by your surgeon. Medications such as sleeping pills, tranquilizers or sedatives MUST be discussed with your nurse anesthetist. Do not drink alcohol, wine, or beer for 24 hours following anesthesia.
  6. Intake of foods and fluids following surgery will be dictated by the nature of the procedure and are to be determined by the doctor.
  7. Call the nurse anesthetist if you have any questions regarding your anesthesia.
  8. Important: Please do not leave the patient in the car or at home alone while you get the prescriptions filled. Try to do this ahead of time, perhaps while you are waiting during the procedure, if possible. If not, please ask the doctor to call your prescription in to your local pharmacy.