SDS Accreditation Update

AAAASF changes its anesthesia requirements

Reports of adverse events, including the death of a cosmetic surgery patient, after administration of propofol by RNs have resulted in a change in anesthesia standards for some organizations accredited by the Gurnee, IL-based American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF).

Facilities that want to use propofol must meet standards set for "Class C" facilities. AAAASF accreditation recognizes three types of same-day surgery programs:

• Class A at which all procedures are performed in the facility under local or topical anesthesia only.
• Class B at which procedures are performed under local or topical anesthesia, intravenous or parenteral sedation, regional anesthesia, analgesia, or dissociative drugs without the use of endotracheal or laryngeal mask intubation. Inhalation general anesthesia nitrous oxide is not permitted at Class B facilities.
• Class C at which all types of anesthesia are used, including endotracheal or laryngeal mask intubation and inhalation anesthesia administered by an anesthesiologist or certified registered nurse anesthetist (CRNA).

Class B facilities that want to continue to use propofol, even for conscious sedation, but will not use other general anesthesia, can comply with the new standard by completing a form that certifies that there is an anesthesiologist or CRNA administering the propofol. The facility also must have neuromuscular blocking agents on-site, according to AAAASF standards.

For details of the changes, go to www.aaaasf.org and click on "Standards" on the left navigation bar, then choose "Standards change for B facilities." A list of rules and requirements for B facilities that need to move to C facility status is included, as well as a copy of the certification form for B facilities that will not be using any other general anesthesia.