ASC Weight cut off

[turnupthevapor]

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Anybody belief in a cutoff for weight (or BMI, Neck circumfrence, etc) for surgicenters?

I am not sure how I feel but obviously tackling a 350 pounder with out any backup has more risk than a 200 lb'er.

Do you ever cancel a surgicenter case cause your intimated by the airway? Or maybe I should grow a pair?

 

[IN2B8R]

Every case gets evaluated on an individual basis (pts come in for a pre-op/AW eval days before they come to surgery center--as instructed by the surgeon). If in the judgement of anesthesiologist they are not suited for a surgery center, the case gets done at the hospital across the street. Any conflict with surgeon is therefore fully avoided.

Anybody belief in a cutoff for weight (or BMI, Neck circumfrence, etc) for surgicenters?

I am not sure how I feel but obviously tackling a 350 pounder with out any backup has more risk than a 200 lb'er.

Do you ever cancel a surgicenter case cause your intimated by the airway? Or maybe I should grow a pair?

 

[SleepIsGood]

Seems like a reasonable thing to be concerned about. I think you are doing the smart thing. If the a/w looks unfavorable, dont risk it.

 

[siednarb]

i work at an ASC every 3rd week - we used to have a cut off of a BMI of 35 which then got moved to 40 and now stands at 45 because they ASC felt they were excluding too many patients that would then revert back to the hospital.

Now with the limit set at a BMI of 45 I've been asked by the RN's who pre-screen the patients scheduled "hey doc, would you be o.k. a BMI for this case - it's just a small local/sed podiatry case...."

IMHO they are keep pushing the envelope in a bad way and whenever you have the words "it's just a _________" you are looking for trouble.

 

[SleepIsGood]

Also from a technical stand point, the OR beds have weight limits.

 

[pd4emergence]

We don't do known difficult airways at our outpatient center. As for weight, anybody with a BMI more than 38 gets to come in and we take a look at their airway. If their airway looks ok we will usually do the case. We don't have a cut off but we have moved cases because of the combination of weight and procedure type. A 400 lb pt for a lap chole at the surgery center is just not good medicine.

 

[Noyac]

Our cutoff is a BMI of 50.

 

[Licoricestick]

Our cutoff is a BMI of 50.

BMI of 49 for day surgery.... GULP

 

[deleted87051]

We have a big bariatric practice, over 12000 cases to date so we are used to big patients. We still maintain a BMI=40 limit at our freestanding ASC. This includes topical cataracts and podiatry cases.

 

[Dirtball]

No absolute cut-offs here, but we are not "allowed" by state regs to do ASA 4. OR table and stretcher limits have come into play for me. Not seeing Pt's pre-op I have sent a couple heavy's packin after taking procedure type, airway , and time of day (who else is there) at my free standing ASC , into consideration.