WPS Orientation Checklist.
The following guidelines are to assist physicians when they provide
anesthesia services to Wilmington Plastic Surgery’s office:
1. Upon arrival, check the main oxygen supply tanks, there are two H
cylinders and if either cylinder is under 500 lbs. Please ask the
nurse to order a replacement cylinder.
2. Scrubs are provided by AAI. They arelocated in the anesthesia workroom or in the changing area by thelocker. The scrubs are picked up by the cleaners on Monday and Thursday and there is a bag with AAI Office Based Anesthesia tag on it in the oxygen tank closet.
3. In the small storage area/anesthesia workroom are the anesthesia
supplies, additional medications and all items needed to start an
intravenous line access. Please familiarize yourself with the
supplies located in this room.
4. The only medications that are not provided are in the two
different locations:
1. Narcotics are located in the locked drawer in the workroom.
The nurses will show you where the key is to unlock the
drawer. A medication logbook must be used to identify waste
and narcotics used.
2. Additional in the refrigerator, in that same area (a small
brown refrigerator) is located any medications that require
refrigeration including but not limited to Succinycholine,
Nimbex, and potentially Diltiazem.
5. Located in Operating Room #1 is a full-service machine and a cart
with all medications. Routinely used in all cases are Ketamine,
Versed, Fentanyl, Propofol and usually Cefazolin for an
antibiotic. These are all easily accessible. Other medications
need to be checked. If any medication is used and not restocked
from the workroom when you have completed your case, please write
up a list so that they can be ordered from Southern Anesthesia.
This is particularly true of any medications for nauseaprophylaxis.
6. The anesthesia machine should be checked out fully. At the end of
the case, be sure that the oxygen analyzer is turned off and the
machine is turned off to prevent oxygen depletion from the main H
cylinders. On the back of each machine there are Nitrous and
oxygen E cylinder. No air supply is available on the current
anesthesia machine.
7. Each patient will receive a full preoperative evaluation. There
are usually no laboratory values for the patient. You may be asked to review and approve patients for future cases.
8. It is expected that we will start the intravenous access on all
patients. Time to start the IV is not included in the anesthesia billing time. It may be started in pre-op or the OR.
9. The patients usually walks to the operating room and then receives
sedation. The patient usually returns to the recovery area in a rolling recliner.
10. The expected length of stay in the recovery area is approximately
30-40 minutes.
11. A Physician must stay until the patient has gone to the car and leftthe facility. You may leave if the patient is stable and there is a MD in the office.
12. Always check the schedule for the next day, as there are
cancellations, reassignments and other problems that can develop.
The schedule is quite flexible, as the patients occasionally have
not decided on their procedure.
13. There is a narcotic logbook in the narcotic closet. Please confirm counts at the end of each day and lock the safe. A copy of the record stays in the narcotic closet.
Overall the nurses are very helpful there. Please ask them if you are
missing anything or need any medication or equipment. They can usually
find it quickly and provide it to you.