title: Practical considerations in the development of a nonoperating room anesthesia practice.
abstract: OBJECTIVE
  More than 25% of the procedures necessitating an anesthesia provider's involvement are performed outside the operating room. As a result, it is imperative that the expansion of anesthesia services to any new nonoperating room anesthesia (NORA) location takes into account the challenges and safety considerations associated with such a transformation.
  
  
  RESULTS
  Although the adverse events encountered in the NORA suite are similar to those met in the operating room, the frequency and implications are different. In addition, many adverse events are site specific. Hypoxemia events, including cardiac arrest continue to dominate all areas of NORA practice. Challenges posed by new minimally invasive procedures continue to grow. Electronic documentation is rapidly expanding into the NORA suite, which brings both advantages and challenges.
  
  
  CONCLUSIONS
  Involvement of anesthesia providers at the development stage and an understanding of the administrative and clinical challenges are essential elements in the building of a NORA practice.
authors.affiliation: aDepartment of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA bDepartment of Anesthesia, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina cDepartment of Anesthesia, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Basavana
authors.initials: B
authors.lastname: Goudra
authors.forename: Adrian
authors.initials: A
authors.lastname: Alvarez
authors.forename: Preet Mohinder
authors.initials: PM
authors.lastname: Singh
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000072080:Anesthesiologists; D000776:Anesthesiology / Q000295:instrumentation*; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects*; D057286:Electronic Health Records; D004724:Endoscopy / Q000009:adverse effects*; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced / Q000517:prevention & control; D007400:Interprofessional Relations; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D059408:Pain Management / Q000379:methods*; D000073818:Procedural Pain / Q000517:prevention & control; D061214:Patient Safety; D018579:Patient Selection
chemical_list: D000777:Anesthetics