In recent years, the number of non–operating room anesthesia (NORA) procedures has increased significantly. At our institution—Morgan Stanley Children’s Hospital of New York-Presbyterian—40% of all anesthesia procedures (∼4000/10,000 cases) were done outside of the operating room in 2011, in contrast…
An increasingly large number of anesthetic cases are performed outside the traditional operating room environment. Procedures performed in areas such as the electrophysiology laboratory and interventional radiology department are becoming more complicated and often take longer. Patients are presenting with…
Acknowledgments The authors would like to thank Kurt Smith and eppstein uhen architects in Madison and Milwaukee, Wisconsin, for their generous donation of time and expertise to the composition of this chapter. Non–operating room anesthesia (NORA) services are being increasingly…
The past two decades have seen advances in medical technology that now allow physicians to treat a patient with noninvasive or minimally invasive procedures. Patients who would have been subjected to sternotomy, thoracotomy, major vascular surgery, or laparotomy just a…
HEALTH, HEALTH CARE, AND CLIMATE CHANGE Climate change represents a defining challenge of our times, and tackling climate change could be the greatest global health opportunity of this century. Climate change poses clear environmental, technologic, and economic challenges that affect…
INTRODUCTION Human interest in sleep is as old as humanity itself, but the specialty of sleep medicine is less than 50 years old. The characterization of sleep into periods based on electroencephalography (EEG) and the presence or absence of rapid…
INTRODUCTION Patients with serious illnesses often have an intense burden of symptoms that are poorly treated, such as pain, dyspnea, anxiety, and depression. These patients also have frequent but often unsatisfying interactions with the health care team, often as a…
INTRODUCTION Clinical anesthesia practice is often considered a model for quality and safety in medicine. In 1999 the Institute of Medicine report, “To Err Is Human” specifically identified anesthesia as “an area in which very impressive improvements in safety have…
INTRODUCTION Background Injury is the leading cause of fatality worldwide, causing more than 5 million deaths—9% of the world's deaths—each year. According to the Centers for Disease Control and Prevention (CDC), trauma accounted for nearly 230,000 U.S. deaths in 2018,…
INTRODUCTION The practice of anesthesiology historically focused on the care of an individual patient undergoing surgery. The specialty has an impressive track record for improving quality and safety in patient care (also see Chapter 46 ). Although anesthesia practice continues…