A Day at the Outpatient Surgery Center

UVA Outpatient Surgery Center

Ambulatory Anesthesia at UVA Battle Building
2020 update provided by Stephanie Caldwell, Residency Class of 2022

OPSC Ambulatory

The University of Virginia Outpatient Surgery Center is located in the Battle Building on West Main Street by “the Corner.” It is directly connected to the Main Hospital via a skybridge. It has twelve operating rooms and a two-phase post anesthesia care unit. Surgeons from several different specialties perform procedures at the center. Approximately half of all pediatric procedures are performed there. The ambulatory rotation provides an exceptional view into the potential “private practice” anesthesiology work environment as well as a nice change of scenery from the Main Operating Room. The pace is much quicker, with rapid turnover and generally shorter surgeries in healthier patients. Because a good portion of the cases also involves pediatrics, we have a dedicated pediatric anesthesia rotation at the Battle building. A day of outpatient pediatrics might look something like this:

0630: Arrive to OPSC and start to set up my room for the day. We have 10 cases today involving GI procedures – EGDs and colonoscopies. The room will move quickly so I am sure to set up multiple IV kits!

0700: Meet with my attending for the day, Dr. Joseph O’Brien. We briefly discuss the different ways to safely conduct anesthesia for pediatric GI cases and then it is off to pre medicate the first patient, a 15 month old with reflux.

0725: We get in the room early after a successful pre medication. We mask the child to sleep and I place an IV while Dr. O’Brien maintains the airway. Given the patient’s age, we decide to place an ET tube. So after the IV placement, I take over the airway and place the ETT.

0750: The procedure is finished and we are able to extubate the patient without incident. It is a quick jaunt to PACU and then head straight back to the room to prepare for the next case.

1130: We have completed 5 cases so far when one of our pediatric CRNAs is able to come in and offer to do the next cases so that I am able to eat some lunch. I gratefully accept her offer and tell her about the next case, a 5 year old with EOE.

1545: We finish the final case in our room and take the patient to PACU. I am the late OPSC resident today so I will be the last person to leave after all the patient’s leave PACU, recovered from their anesthetic. I take a break and then am able to get out one of my colleagues from an orthopedic room.

1730: The last case of the day at the outpatient surgical center finishes and is taken to PACU. I now am able to help our PACU nurses handle a case of nausea following her knee arthroscopy.

1930: Finally, the last patient is discharged from PACU after a bout of nausea. The patient is doing much better and is grateful for her care today. I head home and get ready to come back tomorrow for a day of pediatric ENT! As a bonus, I will be the first resident out tomorrow and I anticipate a short day!

updated October 2020