Fastest time from receiving pt to GA

sonessrna · Feb 15, 2005

Hi,
I was wondering how long it takes folks, if you are thorough but moving right along, from receiving a patient to start of GA. Including interview, equipment check, paperwork, etc.
Thanks!

probably around 15 minutes until the patient is asleep.

heartICU · Feb 16, 2005

Hi,
I was wondering how long it takes folks, if you are thorough but moving right along, from receiving a patient to start of GA. Including interview, equipment check, paperwork, etc.
Thanks!

I set up my room and go my equipment check before the patient gets there...it takes me a little while to get going in the morning, so I usually take my time setting up...the machine check and room setup takes me about 30 minutes...although I have done it in ten minutes when I am running late.

Once the patient gets there, I go into the alcove and talk to them. The majority of our patients are seen through our PACE clinic, and therefore have already had an interview/assessment with an anesthesia provider. I look up their PACE note the night before, so I have a general idea of what to expect. I go over their med history with them, make sure no changes have occurred from their H&P, check and see when meds were D/C'd (if appropriate), do an airway assessment, etc and bring them into the room. Takes about 5 minutes to hook them up to monitors, get them positioned on the table, reiterate with them what is going to happen. Then I have to wait on my staff (my particular hospital uses an care team model, so MD is present for induction). They introduce themselves, ask if the patient has any questions, then we go to sleep. Altogether, if there are no delays (OR nurses are ready for patient, MD isn't tied up in another room, all lab work is back, etc), I would say fifteen minutes from when they are outside the room to when induction starts. Again, that tiem can increase if you are waiting on others, or there is faulty equipment in the OR (OR tables that have broken kidney rests seem to be happening to me quite a bit laterly), or if the patient is challenging (difficult airway, hemodynamically unstable after induction). It can also decrease...rapid sequence induction, or if the patient needs to be emergently intubated. In my experience, induction usually takes a little longer rather than shorter because we are usually waiting on someone else.

I read some of your other posts, about awareness. Did you have an unusually long or short time between the beginning of your care and onset of GA?

Mana_Tangata · Feb 16, 2005

I set up my room and go my equipment check before the patient gets there...it takes me a little while to get going in the morning, so I usually take my time setting up...the machine check and room setup takes me about 30 minutes...although I have done it in ten minutes when I am running late.
Once the patient gets there, I go into the alcove and talk to them. The majority of our patients are seen through our PACE clinic, and therefore have already had an interview/assessment with an anesthesia provider. I look up their PACE note the night before, so I have a general idea of what to expect. I go over their med history with them, make sure no changes have occurred from their H&P, check and see when meds were D/C'd (if appropriate), do an airway assessment, etc and bring them into the room. Takes about 5 minutes to hook them up to monitors, get them positioned on the table, reiterate with them what is going to happen. Then I have to wait on my staff (my particular hospital uses an care team model, so MD is present for induction). They introduce themselves, ask if the patient has any questions, then we go to sleep. Altogether, if there are no delays (OR nurses are ready for patient, MD isn't tied up in another room, all lab work is back, etc), I would say fifteen minutes from when they are outside the room to when induction starts. Again, that tiem can increase if you are waiting on others, or there is faulty equipment in the OR (OR tables that have broken kidney rests seem to be happening to me quite a bit laterly), or if the patient is challenging (difficult airway, hemodynamically unstable after induction). It can also decrease...rapid sequence induction, or if the patient needs to be emergently intubated. In my experience, induction usually takes a little longer rather than shorter because we are usually waiting on someone else.
I read some of your other posts, about awareness. Did you have an unusually long or short time between the beginning of your care and onset of GA?

My anesthesia record shows that the anesthesia "start" was 10 minutes after I entered the department. I don't remember him asking me about previous anesthesia experiences, or current medications, and he did not document anything. I had written a letter to my surgeon about setting off alarms when I was sedated for a minor procedure due to my low heart rate, but she did not inform the anesthesiologist or put it in my chart. It's hard for me to tell if he did a baseline reading or not - the initial BP and HR reading is the same minute as "anesthesia start".