nonORS

Non-Operating Room Services (non-ORS) refers to anesthesia and perioperative care delivered outside the conventional operating room. This includes sedation, monitored anesthesia care, general anesthesia, or regional techniques used for procedures in environments such as interventional radiology suites, endoscopy units, dental clinics, cardiac catheterization labs, radiology suites, and ambulatory surgical centers. The aim is to provide safe, comfortable anesthesia care tailored to the procedure and the patient, with rapid recovery when feasible.

Key elements of non-ORS care include preprocedural evaluation and risk assessment, appropriate selection of the anesthesia level, continuous monitoring, and readiness to convert to a higher level of anesthesia if needed. Continuous monitoring typically involves ECG, pulse oximetry, noninvasive blood pressure, capnography, and temperature, with airway management equipment readily available. An anesthesia professional such as an anesthesiologist or certified registered nurse anesthetist often oversees care, supported by trained staff and standardized protocols.

Settings and challenges: Non-ORS environments can present space constraints, infection control considerations, and limited access to full operating room support. Procedures may involve imaging equipment and radiation exposure, requiring coordination with other teams and adherence to safety standards. Equipment portability, planful setup, and clear communication are essential to patient safety and efficiency.

Safety, guidelines, and outcomes: Professional societies issue guidelines and position statements to promote safe non-ORS anesthesia, covering credentialing, staffing, perioperative assessment, and quality metrics. When properly planned and executed, non-ORS anesthesia can achieve safety and outcome profiles similar to traditional operating rooms, though risks vary by site, procedure type, and patient factors.