Eating before surgery: Every patient entering the operating room needs to follow strict guidelines for eating before receiving sedation or anesthesia. These guidelines follow the recommendations of the American Society of Anesthesia. They are in place for patient safety. A patient receiving sedation or anesthesia does not maintain airway reflexes and is at risk for aspirating stomach contents during the anesthetic. Although every precaution is taken by the anesthesia provider stomach contents can come up the esophagus and enter the oral cavity. Serious problems can occur should those contents go into the lungs. Following the Preoperative Fasting Guidelines (See "Department Links") will minimize a patient’s risk of problems by minimizing the type and volume of stomach contents. Not following these guidelines will likely result in cancellation of elective procedures. In the case of emergency surgery, the anesthesia provider uses techniques to limit aspiration risk. The guidelines below are provided to patients during preoperative visits.

The Day of Surgery

When a patient comes to the hospital for surgery at Kaiser San Francisco , he or she will first check in with the admitting office. Following that the patient will procede to the fourth floor to the Ambulatory Surgery Unit (ASU) where they will present to the receptionist. At the proper time the patient will be asked to come into the ASU unit where pereparation for surgery begins. Proper procedure attire, usually a hospital gown, will be provided and vital signs will be talken, while and ASU RN provides information, answers questions, discusses the events of the day, and, in most cases, places an intravenous line, called an IV for short. Occasionally the nurse will provide medications as indicated for the upcoming procedure and medical history based on doctors orders or hospital patient safety and quality protocol. Patients have many opportunities to ask questions about the day's events or their treatment plan.

Once adequately prepared and at the appropriate time, the patient will be brought to the preoperative area. It is at this point that the patient will be introduced to the anesthesia department. Our team approach provides that several members of our anesthesia team may be involved with your surgical preparation. Patients meet their OR nurse and surgical staff at this time as well. Along with a surgical technician, these individuals make up your OR Care Team. Each member of this team will ask questions and gather information that ensures you are the proper patient having the proper procedure for the proper indications. After these safety checks, the anesthesia provider will provide supplemental medications for anxiety and discomfort as needed and will perform necessary pre-surgical anesthesia procedures as indicated. Each patient has different needs for anesthesia, so each patient receives customized care based on these needs.

After a proper preoperative evaluation and presurgical check, the patient will be brought to the operating room or procedure area for the procedure. Appropriate monitoring will be set up and the anesthetic and procedure will be performed. Upon completion of the procedure, anesthesia will be discontinued and the patient will be brought to the recovery room (PACU) for further monitoring. The anesthesia provider informs the PACU nurse and physician of the details of the procedure and what the appropriate PACU plan should be. The PACU patient is then monitored for the appropriate amount of time before being discharged back to the ASU for further recovery or to the hospital ward for further hospital care. The PACU and ASU staff remain in close contact with the PACU anesthesiologist in order to provide the best possible care to the patient.