Holzman R S, Cullen D J, Eichhorn J H, Philip J H
Department of Anaesthesia, Harvard Medical School, Boston, MA.
J Clin Anesth. 1994 Jul-Aug;6(4):265-76. doi: 10.1016/0952-8180(94)90072-8.
The increasing use of sedation to enhance patient comfort during diagnostic and therapeutic procedures has been noted by the Joint Commission of Accredited Healthcare Organizations, specialty societies, and the public. Although anesthesiologists, by virtue of training and experience, possess unique qualifications to provide such sedation services, their availability remains somewhat limited by primary commitments to the operating room, intensive care unit, or pain service. The Risk Management Committee of the Department of Anaesthesia of Harvard Medical School has made specific recommendations to the Harvard-affiliated hospitals for anesthesiologists who participate in institutional-level committees in setting guidelines for such services when they are provided by nonanesthesiologists. Specific consideration is given to facilities, backup emergency services, equipment, education and training, issues of informed consent, documentation, and release of patients from medical care. These recommendations emphasize the collaboration of the department of anesthesia and other departments that provide sedation services in formulating policies and procedures that reflect values intrinsic to the practice of anesthesiology.
认可医疗机构联合委员会、专业协会以及公众都已注意到,在诊断和治疗过程中为提高患者舒适度而增加使用镇静剂的情况。尽管麻醉医生凭借培训和经验具备提供此类镇静服务的独特资质,但由于他们主要负责手术室、重症监护病房或疼痛治疗服务,其可提供服务的时间仍较为有限。哈佛医学院麻醉学系风险管理委员会已向哈佛附属医院提出具体建议,针对非麻醉医生提供此类服务时,参与机构层面委员会制定相关服务指南的麻醉医生。具体考虑因素包括设施、备用应急服务、设备、教育与培训、知情同意问题、文件记录以及患者出院事宜。这些建议强调麻醉学系与其他提供镇静服务的部门合作,制定反映麻醉学实践内在价值的政策和程序。