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FEATURE


Keep your staff informed, Taylor recommends. “ASCs often contract anesthesiologists,” he says. “You have to educate your contracted workers/ end users of the extended-use drugs protocols you put in place in your ASC. Education and awareness are critical.” To complete the circle, anytime


you have your medication manage- ment or board of director meetings, document the extended use drugs situ- ation in the minutes. “That keeps your medical staff informed,” Taylor says.


Drugs Not on the FDA List “My main concern is propofol,” Sones says. “A high percentage of propo- fol comes from Italy, which has been severely hit by COVID-19. This drug will become problematic exacerbated


by shrinkage from Italy. Equally of concern are cefazolin/i.e. Ancef, fen- tanyl, midazolam, epinephrine-con- taining products, dantrolene (Revonto made in Italy) and IV solutions.” Review formulary options with your medical director, anesthesia lead and governing body, if one of the five drugs mentioned above disappears from the


market, he says. “In the case of cefazo- lin, one drug for consideration is cefu- roxime (Ceftin, Zinacef). Perhaps more costly, but it is a therapeutic option. Antibiotic use in most routine GI proce- dures continues to not be recommended by the American Society for Gastroin- testinal Endoscopy.” Should the fentanyl shortage


evolve, consider less desirable opi- oids, i.e., meperidine. “Some com- pounders have begun to provide fentanyl product. Assure the vet- ting process should you engage a new compounder. Cost basis will be higher,” Sones says. For more information on the corona-


virus and ASCs, visit ASCA’s COVID-19 Resource Center at ascassociation.org/ covid-19.


ASC FOCUS JUNE/JULY 2020 | ascfocus.org


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