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Anaesthesia for non-theatre environments 

Anaesthesia for non-theatre environments
Chapter:
Anaesthesia for non-theatre environments
Author(s):

Chris Dodds

, Chandra M. Kumar

, and Frédérique Servin

DOI:
10.1093/med/9780198735571.003.0013
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date: 11 December 2019

This chapter reviews the challenges in providing safe anaesthesia outside of the operating theatre complex and the particular risks this may pose to the elderly. Generic issues with remote sites are discussed, and key points are identified: these include patient assessment, appropriate staffing and support, safety drills, environmental safety, and anaesthetic equipment and drug provision. Sedation in the elderly is identified as an area of risk, and the chapter details the problems of providing safe sedation. The areas where sedation is administered vary from endoscopy and imaging including CT and MRI, to interventional suites such those used for cardiothoracic catheterization and GI stenting. Major advances in technology have allowed the development of endovascular aortic aneurysm repair (EVAR) and transthoracic aortic valve implantation (TAVI). Psychiatric units still prescribe electroconvulsive therapy (ECT) for severe suicidal depression, especially in the elderly because of the fast response, and the related challenges for anaesthetists are reviewed.

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