Strategies for daily operating room management of
ambulatory surgery centers following resolution of the
acute phase of the COVID-19 pandemic
Joint Statement: Roadmap for Resuming Elective Surgery after COVID-19 Pandemic
The ASA, the American College of Surgeons (ACS), American Hospital Association (AHA) and Association of periOperative Registered Nurses (AORN) have developed a “Roadmap for Resuming Elective Surgery after COVID-19 Pandemic.”
CMS has also issued recommendations regarding - Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I
Statements and Guidelines on Elective Surgery
CMS has recently announced new recommendations, "Adult Elective Surgery and Procedures Recommendations: Limit all non-essential planned surgeries and procedures, including dental, until further notice."
Below are links to current statements and guidlelines on Elective Surgery. The Iowa Society of Anesthesiologists supports these statements cancelling all non-essential surgical cases.
CMS Statement - March 18, 2020
ISA 2020 Spring Conference - CANCELLED
In light of the ongoing COVID-19 situation, the ISA Board has cancelled our 2020 ISA Spring Meeting.
The ISA Fall Conference is scheduled for Friday evening, September 18th and all day Saturday, September 19, 2020 in Iowa City so we hope that you will be able join us then.
Below are some resources to keep you up to date on the Coronavirus.
- Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins
- Coronavirus Disease (COVID-19) – Statistics and Research – Our World in Data
- Coronavirus Disease (COVID-19) Advice For The Public - World Health Organization
- What to Do if You Are Sick? CDC Information
- CDC Print Resources
- Iowa Department of Public Health
- What to do When a COVID-19 Patient Needs an Operation
- CDC Criteria for Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19
The Iowa Board of Medicine has adopted amendments to the standards of practice for appropriate pain management, which were effective on November 27, 2019. They reference the U.S. Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain.
These amendments require a physician to register with the Iowa Prescription Monitoring Program at the same time that the physician applies for registration or renews registration to prescribe controlled substances as required by the Iowa Board of Pharmacy.
These amendments also require a physician or the physician’s designated agent to utilize the Iowa Prescription Monitoring Program prior to issuing an opioid prescription and, beginning January 1, 2020, to transmit electronically as an electronic prescription every prescription for controlled and noncontrolled substances. This rule making makes it a ground for discipline if a physician prescribes opioids in dosage amounts exceeding what would be prescribed by a reasonably prudent physician in the state of Iowa acting in the same or similar circumstances. This rule making also encourages the use of nonopioid pharmacologic therapy and nonpharmacologic therapy.
A copy of the IBM final rule is available here.
Iowa Pharmacy Board Rules
During the 2018 Legislative Session, the Iowa Code was amended to require the electronic transmission of all prescriptions as of January 1, 2020. The amendments to the Iowa Code provided exemptions for prescriptions which will not be required to be transmitted electronically. The amendments provided that a prescriber, medical group, institution, or pharmacy that is unable to comply with the electronic prescription mandate may petition the Board for an exemption.
A prescriber, medical group, institution, or pharmacy seeking an exemption beginning January 1, 2020, shall submit a completed petition no later than October 1, 2019.
The amendments required the Board to adopt rules to establish the form and specific information to be included in a request for such an exemption and the specific criteria to be considered by the Board in determining whether to approve a request for exemption. This rule making implements the electronic prescription mandate.
A copy of the final rules is available here.
ASA 2019 Legislative Conference
The ISA had a strong contigent of officers, directors and residents that attended the 2019 ASA Legislative Conference. Members were able to discuss key healthcare issues with our Iowa Congressional delegation including out-of-network billing and Medicare for All.
Iowa Dental Board Updates Anesthesia Rules
The Iowa Dental Board has voted to update their anesthesia rules.
This rule making updates requirements for providing moderate sedation, deep sedation and general anesthesia in dental offices. This rule making specifies the conditions under which the administration of the sedation services may be performed by another health care provider, such as an anesthesiologist or nurse anesthetist.
This rule making establishes a requirement for training in the monitoring of patients under moderate sedation, deep sedation or general anesthesia. Due to the increased risk of these levels of sedation, the training would allow an option to focus on additional training in observation of a patient under sedation and prepare staff to recognize signs of an adverse reaction or occurrence.
This rule making establishes a prohibition of the use of drugs intended for deeper levels of sedation from being employed for the purposes of moderate sedation. This rule making clarifies the facilities and locations subject to inspection and the equipment required to be maintained at each facility where moderate sedation, deep sedation or general anesthesia, or all three, are performed.
A copy of the rules is available here.
Dr. Scott Paulsen, ISA President, and Dr. Frank Cassady, ASA State Director, recently participated on the Simon Conway radio show on WHO. They discussed concerns with the VA Proposed Rule to allow all ARNPs to practice independently within the VA system. They stressed that Veterans deserve, and have earned the right to receive, the best medical care possible. Additionally, they highlighted the fact there is no shortage of physician anesthesiologists in the VA system and that the current team-based model of anesthesia care is serving Veterans safely and effectively.
To listen to the interview, go to: http://tinyurl.com/j6evhj9 and scroll down to the first link, “Simon Conway Show 7/13 Hour 2” and click on the play button.