CA2 residents have a required rotation in the Ambulatory Surgery Center (ASC), which is located adjacent (but connected by a covered walkway) to the main hospital campus. CA3 residents often take this as a senior elective.
The ASC was designed to emulate a private practice environment, implementing a teamwork approach where we all work to create a high level of patient and family satisfaction. Care is provided by anesthesiologists, CRNAs, surgeons, and nurses specially trained in outpatient perioperative care. The physical status of ASC patients ranges from healthy children and young athletes to octogenarians with a number of comorbidities.
The focus of this rotation includes safe and efficient patient care and the application of protocol-driven anesthesia to reduce variation in care and to optimize safety and patient outcomes.
Methods for accomplishing this include:
- Regional anesthesia and analgesia (spinals, epidurals, or peripheral nerve blocks)
- Application of multimodal analgesia
- Total IV anesthesia
- Avoidance of opioids
- Avoidance of post-operative nausea and vomiting
All of these items help to facilitate ambulatory anesthesia goals, including:
- Smooth timely induction
- Rapid emergence
- Post-anesthesia care unit bypass
- Excellent pain control
- Very low rates of postoperative nausea and vomiting
- High level of patient and team satisfaction
The ASC at the University of Iowa Hospitals & Clinics has 12 ORs with state-of-the-art technology; children and adults have separate care areas with private pre-op and post-op rooms. With the opening of the UI Stead Family Children's Hospital, most of the pediatric patient anesthesia has been relocated there.