• Day case guidance
  Link:www.aagbi.org/sites/default/files/Day%20Case%20for%20web.pdf
  
• Aim: 75% of operations to be done as day case in the NHS
• Recommendations
• Protocols for procedures can improve success
• Self contained unit
• Enhanced recovery programmes are based on established day surgery principles
• Effective audit should be ongoing
• Good quality advice leaflets
• Every unit should have a clinical lead in charge of guidelines, policies and clinical governance
• Anaesthetists should develop techniques to optimise chance of discharge
• CNB and nerve blocks can be used for day surgery
• Acute conditions may be managed by day surgery via a semi-elective pathway
• Fitness based on patients health as as determined by pre-op preparation and not limited by arbitrary limits eg ASA grade, age or BMI
• Effective pre-op preparation and protocol driven, nurse led discharge is key
• Surgical factors
• No significant chance of serious complication
• Pain controllable by local techniques and oral medication
• Procedure should enable oral intake within a few hrs
• Usually be able to mobilise but full mobilisation is not essential
• Medical factors
• Chronic stable disease can be managed safely
• Obesity is not a CI and may benefit from early mobilisation
• Fitness based on patients health as as determined by pre-op preparation and not limited by arbitrary limits eg ASA grade, age or BMI
• Social factors
• Must understand planned procedure and post-op care and consent to day surgery
• Responsible adult should escort home and support for 24 hrs
• Domestic circumstances must be appropriate