Vancouver Acute Department of Anesthesia

Guidelines for Anesthesia involvement in ICU patients requiring Interventional Radiology Procedures

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Procedure for booking anesthesia cases:

 

• Notification of the request for anesthesia should occur via attending ICU staff OR proceduralist to the in-charge anesthesiologist staff (slater/D1/N1 as appropriate)

• Cases should be formally booked by the proceduralist with the OR front desk

• Further discussion should occur between the in-charge anesthesiologist and the proceduralist (e.g. endoscopist or radiologist) after ICU identifies that an anesthesiologist's involvement is required

 

The following procedures require attendance by an anesthesiologist:

 

1. Interventional radiology procedures for massive pulmonary embolism (PERT activations)

   • *note that a cardiac anesthesiologist is preferred*

2. Interventional radiology procedures associated with hemodynamic or respiratory complications on intubated ICU patients

   • e. g. carotid stenting, aneurysm coiling, TIPS

3. Interventional radiology or endoscopy procedures on non-intubated ICU/HAU (or high-risk ward patients identified by the ICU) requiring sedation

   • e. g. upper endoscopy, ERCP, bronchoscopy

   • High-risk patients include those who are hypoxemic or hemodynamically unstable at baseline, difficult airway, uncooperative, or who have significant comorbidities.

 

Strictly diagnostic procedures (e.g. CT/MRI imaging, cerebral angiography) or simple interventions (e.g. drain insertion) do not require anesthesia support unless specifically requested.

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Last updated: Dec 2016