Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Day case anaesthesiaDay case anaesthesia[Appraised by Dr Robin Correa, January 2010]The lead clinician for day case anaesthesia is Dr Robin Correa. Thesurgical day unit on the ground floor offers care for a variety of daypatients (discharge on the same day) and 23-hour stay patients(discharge before 24 hours elapse).Criteria for day case anaesthesiaThe following criteria are in place to determine suitability for day caseanaesthesia. If as a trainee you are faced with a patient who hasalready been admitted and who you do not believe fits within thecriteria, you should follow the advice on page 46 before cancelling orpostponing a patient.All patients who are ASA grade 3 or have insulin-dependent diabetesmellitus should be pre-assessed to determine their suitability foradmission to the surgical day unit (day stay or 23-hour care). Seepage 155 for diabetic patients on the surgical day unit.Day stay1. The procedure will not normally be associated with significantpostoperative pain or bleeding.2. There is no upper age limit. The lower age limit is one year.3. Maximum ASA class 2 (except as above).4. Maximum BMI 35. Obesity is no longer of itself acontraindication to general anaesthesia in the surgical day unit.However, the clinical guideline in the surgical day unit definesthe acceptable upper limit of body mass index as 35 kg m -2 . Youshould seek senior advice (see page 43) if presented with thissituation.5. Patients who give a history of anaesthetic misadventure or whopose potential airway management issues will not be accepted.190 Anaesthetists Handbook January 2010