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1.   INTRODUCTION

The Australian and New Zealand College of Anaesthetists endorses the concept of monitored care provided by an anaesthetist for a procedure performed under local anaesthesia or sedation. Monitored care may also be required in special situations such as the intravascular administration of contrast medium in a suspected susceptible patient.

Monitored care may be requested by a surgeon, dentist, obstetrician, physician, endoscopist, radiologist, radio therapist, or other proceduralist, or by a patient or his/her carer.

The provision of monitored care may be exacting and time consuming because of the general condition of the patient and, in some cases poor access, the location of the procedure and availability of support staff.

2.   GENERAL PRINCIPLES

2.1   Monitored care shall include:

2.1.1   Performance of a pre-anaesthetic consultation in accordance with College Professional Document PS7 Recommendations on the Pre-Anaesthesia Consultation, including obtaining consent in accordance with College Professional Document PS26 Guidelines on Consent for Anaesthesia or Sedation.

2.1.2   Monitoring of the patient, as appropriate, in accordance with College Professional Document PS18 Recommendations on Monitoring During Anaesthesia.

2.1.3   Administration of intravenous sedation, if required, in accordance with College Professional Document PS9 Guidelines on Conscious Sedation for Diagnostic, Interventional Medical and Surgical Procedures.

2.1.4   Other therapeutic measures as required.

2.1.5   Transfer of the patient, if required, to an appropriate Recovery Area in accordance with College Professional Document PS4 Recommendations for the Post-Anaesthesia Recovery Room.

2.2   A record of clinical observations and of drugs administered shall be kept in accordance with College Professional Document PS6 The Anaesthesia Record. Recommendations on the Recording of an Episode of Anaesthesia Care.

2.3.   To ensure that standards of patient care are satisfactory, equipment and staffing of the area in which the patient is being managed should satisfy the requirements in the appropriate College Professional Document T1 Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations

COLLEGE PROFESSIONAL DOCUMENTS

College Professional Documents are progressively being coded as follows:

TE Training and Educational

EX Examinations

PS Professional Standards

T Technical

POLICY - defined as 'a course of action adopted and pursued by the College'. These are matters coming within the authority and control of the College.

RECOMMENDATIONS - defined as 'advisable courses of action'.

GUIDELINES - defined as 'a document offering advice'. These may be clinical (in which case they will eventually be evidence-based), or non-clinical.

STATEMENTS - defined as 'a communication setting out information'.

This document is intended to apply wherever anaesthesia is administered.

This document has been prepared having regard to general circumstances, and it is the responsibility of the practitioner to have express regard to the particular circumstances of each case, and the application of this document in each case.

Professional documents are reviewed from time to time, and it is the responsibility of the practitioner to ensure that the practitioner has obtained the current version. Professional documents have been prepared having regard to the information available at the time of their preparation, and the practitioner should therefore have regard to any information, research or material which may have been published or become available subsequently.

Whilst the College endeavours to ensure that professional documents are as current as possible at the time of their preparation, it takes no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently.

Promulgated: 1990

Reviewed: 1995, 2001

Date of current document: Dec 2006

© This document is copyright and cannot be reproduced in whole or in part without prior permission.

College Website: http://www.anzca.edu.au/