A recent article in the Wall Street Journal informed readers that hospitals are moving to lower the risks associated with anesthesia by using “conscious sedation.” This type of sedation induces an altered state of consciousness that minimizes pain and discomfort through the use of pain relievers and sedatives. Patients, who receive conscious sedation usually are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience to the provider. Fentanyl and Versed are typical drugs used for conscious sedation. A more detailed explanation of conscious sedation can be found at the web site maintained by the American Association of Nurse Anesthetists.
Anesthesiologists and nurse anesthetists are increasingly busy, so surgeons, gastroenterologists, and other professionals are pushing to be able to administer anesthesia themselves. Because training and licensure standards vary from state to state, hospitals are adopting stricter credentialing programs for professionals that administer anesthesia and they have to be re-certified every two years.
One of the problems with the doctors administering the anesthesia themselves is the doctor may be experienced in certain types of anesthesia, but since patients react differently to different drugs, the doctor may not be prepared to rescue a patient who slips into a deeper state or begins having trouble breathing. The risk increases for patients who snore, are obese, have short necks, or excessive facial hair.
Patients may feel more secure and safe receiving anesthesia in a hospital rather than a surgical center or doctor’s office, but this article explains that even in hospitals, anesthesia providers are not always adequately trained. In fact, the University HealthSystem Consortium (UHC) found that 42% of hospitals don’t require their providers to have life support training. That is almost half of the hospitals studied!
According to the article, more than 40% of malpractice claims dealing with the use of sedatives monitored by an anesthesiologist involved death or brain damage, a rate that is similar for general anesthesia claims. Nearly half of these claims could have been prevented if the patient had been appropriately monitored. It should be emphasized that sedative drugs can be very tricky, even when used by an anesthesiologist. Patients may think conscious sedation is safer than general anesthesia, but this assumption is not always accurate.
Patients must ask five important questions before agreeing to sedation for a procedure:
– What kind of anesthesia will I receive, and what are the risks?
– Will I be in moderate or deep sedation?
– How will blood pressure, pulse and oxygen levels be monitored?
– Will there be qualified individuals monitoring your vital signs?
– What emergency procedures and rescue drugs are in place in case there’s a complication?
So, before you agree to that surgery, be certain to ask these questions and make sure you are comfortable with the answers and the safety procedures in place – your life may depend on it!