By Rita Agarwal, MD, FAAP, FASA
Welcome to another episode of Vital Times the California Society of Anesthesiologists’ Podcast with your host Dr. Rita Agarwal.
There have been a lot of questions recently regarding the appropriateness of patients scheduled for care in an ambulatory surgical center (ASCs). It appears that sicker and more complex patients are being scheduled for care in an ASC, and many anesthesiologists are increasingly concerned about the safety of anesthetizing these patients in locations that may lack resources to escalate care if needed. In today’s episode we are going to discuss some of these issues with two experts in ambulatory to help navigate this quandary. Welcome Drs. Christina Menor and Basem Abdelmalak.
Dr. Christina Menor completed her Bachelor of Science in Microbiology from Arizona State University, followed by her Master of Science in Nutrition from Arizona State University. Dr. Menor went on to complete medical education at the University of Arizona in Tucson and Phoenix, followed by Internship in Internal Medicine at St Joseph’s Medical Center in Phoenix. She then came here to LAC+USC to complete residency in Anesthesiology. After completing training, she stayed in Los Angeles at Hollywood Presbyterian Medical Center with heavy practice in obstetric and general anesthesiology. During her time at Hollywood Presbyterian, she became chair of the department for several years, was active on medical staff committees and medical executive roles as Chair of Anesthesiology and Pain Medicine, Chair of Bylaws, Chair of Bioethics, Secretary of Medical Executive Committee before transitioning to a mostly ambulatory group practice in Los Angeles area. In addition to leadership roles at MEC within the hospital she has been actively involved with the California Society of Anesthesiologists and American Society of Anesthesiologists in leadership roles including an elected officer for the past 7 years and currently serves as the President-Elect of the CSA. Dr. Menor serves as a delegate for the small and solo delegation to the California Medical Association.
Dr. Abdelmalak is a professor of anesthesiology at the Cleveland Clinic and on the ASA Board of Directors. He leads NORA Services for Bronchoscopy and is the Quality Improvement Officer and Director of the anesthesiology oversight for procedural sedation. He also performs the Therapeutic Whole Lung Lavage procedure. His clinical interests include anesthesia for ENT, and difficult airway management. As well as NORA ( specially Bronchoscopy). He recently served as a member of the ASA task force on the 2022 ASA Practice Guidelines for the management of the difficult airway. He is the chair of the ASA taskforce on NORA and Procedural Sedation, and recently co-chaired the ASA taskforce on Preoperative Fasting that issued the 2023 NPO guidelines Modular updates, and the Guidance on GLP-1 He has received numerous awards, including Safety Champion by the Cleveland Clinic Quality Institute and co-edited two textbooks titled Anesthesia for Otolaryngologic Surgery and Clinical Airway Management
The discussion was fascinating and informative, starting with why surgeons and proceduralists may want to schedule patients in an ASC, to factors that might affect the decision to safely care for a particular patient in a particular location. Along the way specific examples of patients with complicated medical conditions were presented and discussed in depth.
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