If you’re planning to have surgery at an outpatient center, you’re probably assuming the doctor and his or her team have everything covered. But sometimes making the wrong assumption can cost you your life.
While surgeries that are performed at outpatient centers are typically routine procedures, it’s always possible that something could go wrong, particularly when anesthesia is involved. If that happens to you, you want to make sure your medical team is prepared to handle the situation and has all the resources it needs to do so effectively.
In hospitals, a surgeon can call for a crash cart if a patient experiences a cardiac emergency or other serious complication. Outpatient surgery centers usually have crash carts as well. But not all do – and others don’t keep them as well-stocked as a hospital would. It’s worth asking your doctor about the availability of a crash cart and what it includes. Doing so could save your life.
In addition to the cart’s basic contents, you want to be sure two particular drugs are available. The first is dantrolene (or Dantrium). Very rarely, anesthesia can cause a complication called malignant hyperthermia. It’s not at all common, but when it happens, it can be deadly. Dantrolene can reverse this condition. Hospitals always have it on hand, but it’s less common in outpatient centers. Chances are, you’ll never need it, but you want it to be there just in case.
The second drug is succinylcholine (found in Anectine and Quelicin). This fast-acting paralytic will help your doctor intubate you quickly if you’re suddenly unable to breathe, which is another dangerous complication that can occur with anesthesia use. Some reports have speculated that Joan Rivers may have survived her routine surgery if this drug had been available. But her doctors didn’t have it. Make sure yours does.
In general, having a routine procedure done at an outpatient center is perfectly safe. But it’s worth asking a few questions to make sure the facility is prepared to handle emergencies. If it doesn’t have a crash cart at all, you may want to consider having your procedure done elsewhere, such as at a nearby hospital.
Yours for better health,
Frank Shallenberger, MD