Why does emergency rescue capability matter in anesthesia?

Anesthesia emergencies can develop within seconds. Rescue means recognizing and treating them before lasting harm.

What rescue involves

• Noticing early. Standards from the American Society of Anesthesiologists (ASA) call for a qualified anesthesia professional to stay with you the entire time and to keep checking your oxygen level, breathing, heart, and blood pressure.
• Finding the cause. Many emergencies look alike in the first moments. Someone has to work out which one it is.
• Keeping you breathing and your blood flowing while the cause is treated.
• Leading the team so that everyone in the room knows what to do.
• Deciding what comes next, such as more monitoring, intensive care, or a move to a hospital.

Safety starts before the emergency

Before your procedure, your anesthesia team reviews your health conditions, medicines, and any past problems with anesthesia. ASA standards make an Anesthesiologist responsible for this review and for your anesthesia plan. This review shows what could go wrong for you in particular, so the team can prepare before your care begins.

Rescue takes medical judgment, not only hands-on skill

A blocked airway, a severe allergic reaction, heavy bleeding, a heart rhythm problem, and too much of a sedating medicine can all look the same at first: a sudden drop in oxygen level or blood pressure. The treatment for each one is different. Rescue therefore depends on quickly telling them apart and treating the right one. ASA describes rescue as the work of someone skilled in managing the airway and in advanced life support, who can correct slowed breathing, low oxygen, and low blood pressure.

Sedation can become deeper than planned

People respond to sedation medicines differently. A patient meant to be lightly sedated can drift into a deeper state in which breathing slows. For this reason, ASA says that anyone giving sedation should be able to rescue a patient who becomes more deeply sedated than intended.

Where you have your procedure matters

Hospitals, surgery centers, and doctors’ offices do not all have the same staff, equipment, blood supply, or backup.

• Hospitals usually have the most resources, with emergency and intensive care teams in the building.
• Surgery centers have trained staff and emergency equipment, but a patient who needs more care is usually moved to a hospital by ambulance.
• Offices usually have the fewest resources and often rely on calling 911.

ASA recommends that any office where anesthesia is given have written emergency plans, an emergency cart with a defibrillator, staff trained in advanced life support, and a plan for moving a patient to a hospital.

Questions to ask

• Who will be on my anesthesia team, and what are their qualifications? To learn more, see Who will provide my anesthesia?
• Who is in charge if there is an emergency?
• What emergency equipment and medicines are kept here?
• If I need more care than this facility can give, which hospital would I go to, and how would I get there?
• Is this facility accredited?