What are the challenges to NORA? - ANSWER Think SWAT PNS V
1. Support staff are unfamiliar with anesthetic management/do not recognize
impending critical situations
2. Well-trained adjunct staff are usually far away
3. Availability of supplies can be variable, but you must be able to convert to GA at
any point
4. Times can be variable and unpredictable, making staffing challenging
5. Positioning: Support staff are unaware of unique positioning considerations for a
patient undergoing anesthesia
6. Non-OR suites are usually set up from the perspective of the proceduralist
(making access to patients difficult)
7. Scheduling and communication gap (sometimes concerns of anesthesia provider
are not always validated by proceduralist)
8. Variation of physical set-up or space to accommodate the need of the patient
What are the unique equipment considerations for NORA? - ANSWER Think "O
SCAMPI"
1. Oxygen source/back-up
2. Suction
2. Code cart location
3. Anesthesia machine
4. Airway equipment
, 5. Medications
6. PPV source
7. Patient cart (?)
8. Portable anesthesia machine (ETCO2 IS A MUST)
9. Positioning devices
10. IV supplies/fluid
What are NORA pre-op requirements? - ANSWER 1. Preform a preop assessment
on pt
2. Discuss expectations w/ patient
3. Meticulous set-up
4. Know important things regarding procedure
-Duration
-Degree of stimulation
-Position needed
-What the proceduralist needs from you
-Anesthesia provider proximity to patietn
What is the ASA criteria for Minimal Sedation/anxiolysis?
Responsiveness
Airway
Spontaneous vent
CV Function - ANSWER Responsiveness: Normal response to verbal stimuli
Airway: unaffected
Spontaneous vent: Unaffected
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