Specialist Anaesthesiologist / Spesialis Narkotiseur

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AGREEMENT WITH ANAESTHESIOLOGIST / OOREENKOMS MET NARKOTISEUR

DR PELSER & ASSOCIATES / DR PELSER & ASSOSIATE

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Drs J Hagen; DP Fourie; CC Rawlins; JS Meyer; SC Sacca; D Kapp; J Pozyn; CJ Maree; JG Vorster; LM Pheiffer

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Tel: 018 468 3205 / 7

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THIS PRACTICE IS CONTRACTED OUT / HIERDIE PRAKTYK IS UITGEKONTRAKTEER

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GENERAL INFORMATION

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Kindly read through this entire document and familiarize yourself with the contents. Prepare any questions you may have regarding your anaesthetic and complete the questionnaire on the overleaf to assist your anaesthesiologist in gaining an accurate appraisal of your medical history.

Like your surgeon, the doctor conducting your anaesthetic is a specialist who trained for an additional four years after becoming a general practitioner. This confers the benefit of expertise and advanced techniques to your care.

You should adhere to the following fasting schedule in preparation for any anaesthetic: No food may be taken within 6 hours of the start of the theatre list on which you are booked – unless otherwise instructed by your anaesthesiologist. You may be called for theatre earlier than your scheduled time and must be adequately fasted. It is advisable that you refrain from fasting for longer periods.

Following any anaesthetic, you are prohibited by law to drive or operate any dangerous machinery for a period of 24 hours. You are also strongly advised to avoid making any legal or financial decisions and to refrain from using alcohol or other depressant substances. Following regional anaesthesia you must take precautions not to injure the insensate limb until normal sensation returns (usually after 12-24 hours). Additionally you are advised to remain under capable

supervision for 24 hours after anaesthesia – particularly following day case surgery.

As far as possible your anaesthesiologist will see you in the ward for the preoperative consultation prior to your collection for theatre. However due to unforeseen circumstances it may happen that you will be seen at the theatre complex immediately before your procedure. You are assured of a thorough preoperative evaluation in either instance.

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INFORMATION REGARDING YOUR ANAESTHETIC

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There are various anaesthetic techniques, which may be used for your surgery: general, regional, neuraxial or sedation. Your anaesthesiologist may use any one or a combination of these techniques depending on the clinical scenario surrounding your procedure to provide you the most appropriate and safe anaesthetic.

Your personal preference may contribute to the decision of anaesthetic technique and you are encouraged to discuss this with your anaesthesiologist. In instances of regional or neuraxial anaesthesia you may be awake during the surgery. It is normal to feel touch and movement, but pain must be reported to your anaesthesiologist for prompt management.

Every precaution is taken to deliver a safe and complication free anaesthetic. Despite the correct conduct of an anesthetic, no anaesthetic carries a guarantee and there are known complications or adverse effects, which may include but is not limited to:

Common adverse effects: Postoperative nausea and vomiting, pain, sore throat, drowsiness, disorientation, muscle weakness, lower blood pressure, shallow breathing and shivering.

Rare complications: Damage to teeth, aspiration of stomach contents, injury to the airway, haemorrhage, vascular injury, lung injury, hypoxic brain insult, cardiac arrest, intra-operative awareness, allergic reactions, vascular line infection or emboli and death.

Regional or neuraxial anaesthesia (blocks): nerve injury – temporary or permanent, local anaesthesia toxic reaction, block failure, injury of the insensate limb from lack of protective reactions, infections and haematomas.

This list is by no means exhaustive, but includes the most important complications. In any instance of a complication it will be managed appropriately and every effort made to resolve it. Please discuss any other concerns with your anaesthesiologist.

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INFORMATION REGARDING YOUR ACCOUNT

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This practice is contracted out and the anaesthetic account is separate from that of the hospital and/or surgeon. The “National Reference Price List” has been scrapped and therefore different schemes and plans pay different rates. For this reason your medical aid may not settle the account in full. Additionally, each anaesthesiologist decides his/her own fee according to a prescribed fee structure. A cost estimate may be requested prior to services being delivered. Where a

co-payment is due, it will not exceed R2000 per hour (or part thereof).

The full settlement of the account remains your own responsibility. Terms are strictly 30 days.

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ALGEMENE INLIGTING

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Lees asb. hierdie hele dokument en raak vertroud met die inhoud daarvan. Voltooi asb. die vraelys op die keersy om u narkotiseur in staat te stel om ‘n akkurate indruk van u mediese geskiedenis te kry. U kan ook enige vrae voorberei wat u aan die narkotiseur wil rig.

Soos u chirurug, is die dokter wat u narkose gaan toedien ‘n spesialis wat vir minstens vier jaar verder studeer het na kwalifikasie as algemene praktisyn. Dit verleen die voordeel van kundigheid en gevorderde tegnieke aan u sorg.

Ter voorbereiding vir u narkose moet u volgens hierdie skedule vastend wees: Geen voedsel mag geneem word binne 6 ure van die aanvang van die teaterlys waarop u geskeduleer is – tensy anders deur u narkotiseur aanbeveel. U mag vroër as u geskeduleerde tyd gehaal word en moet genoegsaam gevas het. U word aangeraai om nie vir oormatige lang tye te vas nie.

Na afloop van enige narkose word u wetlik verbied om ‘n voertuig te bestuur of gevaarlike masjinerie te dryf vir ‘n tydperk van 24 uur. U word ook sterk aangeraai om nie enige finasiële of wettige besluite te neem of alkohol en enige ander depressante middels te gebruik nie. Na streeksnarkose moet u voorsorg tref om nie die gevoelose ledemaat te beseer nie, totdat normale sensasie terug keer (gewoonlik na 12-24 uur). Verder word u aangeraai om onder bekwame

toesig te wees vir die eerste 24 uur nadat u narkose ontvang het – veral na dag prosedures.

Sover moontlik sal u narkotiseur u in die saal sien vir ‘n preoperatiewe konsultasie alvorens u gehaal word vir teater. Dit mag egter, weens onvoorsiene omstandighede, gebeur dat u by die teater kompleks gesien word onmiddelik voor u prosedure. In iedere geval word u verseker van ‘n deeglike evaluasie.

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INLIGTING AANGAANDE U NARKOSE

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Daar bestaan verskeie narkosetegnieke wat gebuik kan word vir u prosedure: algemene-, streeks- en neuraksialenarkose of sedasie. U narkotiseur kan enige van hierdie tegnieke of kombinasie daarvan gebruik, afhangende van die kliniese scenario rondom u prosedure, om aan u die mees toepaslike en veilige narkose toe

te dien. U persoonlike voorkeure sal oorweeg word tydens die beplanning van die narkose tegniek en u word aangeraai om dit met u narkotiseur te bespreek. In gevalle waar neuraksiale- of streeksnarkose gebruik word, kan dit wees dat u wakker is gedurende die chirurgie. Dit is normaal om tas en beweging te voel, maar pyn moet dadelik aan u narkotiseur raporteer word om onmiddelik aangespreek te word.

Elke voorsorgmaatreël word geneem om ‘n veilige en komplikasievrye narkose toe te dien. Ten spyte van die korrekte toediening van narkose kan geen narkose gewaarborg word nie en daar is bekende komplikasies en/of newe-effekte wat plaas kan vind en sluit die volgende in, maar is nie daartoe beperk nie.

Algemene newe-effekte: Postoperatiewe naarheid en braking, pyn, keelseer, lomerigheid, disoriëntasie, spierswakheid, laer bloeddruk, vlak asemhaling en bewing.

Seldsame komplikasies: Tandbesering, aspirasie van maaginhoud, lugwegbesering, bloeding, vaskulêrebesering, longbesering, hipoksiese-breinbesering, intraoperatiewe bewustheid, allergiese reaksies, vaskulêrelyn infeksie of embolië, hartarres en dood.

Streeks- of neuraksialenarkose dra die risiko van: senuweebesering – tydelik of permanent, lokaalverdower toksisiteit, faling van die blok, besering aan gevoelose ledemaat weens gebrek aan beskermende reaksies, infeksies en hematoom vorming.

Hierdie lys is geensins volledig nie, maar sluit die mees belangrike komplikasies in. In enige geval van komplikasie sal dit toepaslik aangespreek word en elke poging aangewend word om dit op te los. Bespreek asb. enige kommer wat u het met u narkotiseur.

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INLIGTING AANGAANDE U REKENING

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Hierdie praktyk is uitgekontrakteer en u narkoserekening is apart van die rekeninge van die hospital en/of u chirurg. Die “Nasionale verwysingpryslys” is geskrap en daarom betaal verskillende fondse en planne verskillende fooie. Vir hierdie rede sal u fonds moontlik nie die hele rekening vereffen nie. Verder besluit elke narkotiseur oor hul eie fooi volgens ‘n voorgeskrewe fooistruktuur.’n Kosteberaming kan aangevra word voor dienste gelewer word. Waar ‘n bybetaling

verskuldig is, sal dit nie R2000 per uur (of gedeelte daarvan) oorskry nie.

Die volle betaling van u rekening bly u verantwoordelikheid. Terme is streng 30 dae.

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