SUMMER 2010
Member Spotlight
Member Spotlight
Joseph Bayes M.D.
Massachusetts Eye and Ear Infirmary
243 Charles Street, Boston, MA 02114
Phone: 617 523 7900
Fax (Anesthesia Office): 617 573 4033
www.MassEyeAndEar.org
OAS Member since 2004
Massachusetts Eye and Ear Infirmary main campus
Massachusetts Eye and Ear Infirmary (Mass Eye and Ear) was founded in 1824 by Drs Edward Reynolds and John Jeffries. Since its founding it has earned an international reputation for treatment of diseases of the eye, ear, nose, throat, head and neck, and for contributions to medical research and education. Mass Eye and Ear is the Massachusetts General Hospital's division of ophthalmology and otolaryngology. Mass Eye and Ear staff physicians have an appointment at Harvard Medical School.
Leah Franzone (Student) and Magaret Penny-Capra R.N. welcoming patients to our new surgical suite
Our anesthesia staff includes 22 anesthesiologists (7 part time), 14 Certified Registered Nurse Anesthetists (CRNAs), 3 Nurse Practitioners (NPs), and 3 office staff. Our chief of anesthesia is Dr. Sunil Eappen. Contained with our hospital building of 16 floors, we have (on separate floors) a main operating room theater currently utilizing 14 operating rooms, and a beautiful new 5 room surgicenter (Officially called our surgical suite) which just opened on July 19, 2010. Our anesthesia staff currently are involved in approximately 17,000 cases each year (counting cases in both the main O.R. and our surgical suite) of which almost 50% (8,100) undergo ophthalmic operations. Our anesthesia staff currently provide anesthesia care only at our main campus.
New surgical suite waiting area
The remainder of this spotlight article will focus on our new surgical suite. The medical director of our surgical suite is Dr. Artem Grush, and the nursing administrator is Ms. Kendra Polefka R.N. Our surgical suite volume has grown from about 1500 cases per year when our original surgicenter opened several decades ago, to about 4,800 cases per year.
When all 5 rooms in the surgical suite are running we assign a CRNA in each of the rooms, a nurse practitioner or 6th CRNA to help perform the anesthesia history and physical, obtain an anesthesia consent, and start an I.V. We also assign two anesthesiologists to ensure patients are prepared for their procedure, and when requested, to perform regional anesthesia blocks with sedation.
Charles River and Longfellow Bridge seen from Mass Eye and Ear main campus
About 90% of our surgical suite procedures are ophthalmologic operations. Cataracts are by far the most common ophthalmologic procedure performed in the surgical suite, but we also perform a fair number of vitrectomies, PKs and a variety of other procedures. About 90% of eye operations for adults are performed under regional anesthesia. (Most of these are performed with an extraconal or anterior intraconal block with a 7/8 inch needle. About 15% of our cataracts are performed under topical anesthesia.) About 10% of the surgical suite procedures are minor otolaryngologic procedures. We have the capability of administering general anesthesia for both children and adults.
New surgical suite work area with Jan Robson R.N. and Carol Crowe (Unit Secretary Coordinator)
Although the overwhelming majority of patients are out-patients, we have the capability of admitting patients to Mass Eye and Ear when indicated. We also have the capability of transferring patients to the Massachusetts General Hospital (via a tunnel connecting the two buildings) in the rare situation that they have serious unstable medical conditions.
Dr. Joseph Bayes
My OAS membership has been very helpful in reinforcing the safety of the use of shorter needles for eye blocks. (Almost all the anesthesiologists in our group routinely use a 7/8 inch Atkinson needle for extra and intraconal blocks). Because of information obtained at an OAS meeting we no longer routinely use epinephrine in block solutions containing bupivicaine (epinephrine does not seem to increase the length of effectiveness when bupivicaine is used). In addition my OAS membership has helped educate me and our staff about other anesthesia techniques that increase the success rate and decrease the risk of complications of regional orbital anesthesia techniques.
Dr. Janine Rodrigues (Anesthesiologist) and Susan McKenna R.N. caring for a patient
Our greatest challenge to practice in the last 12-18 months has been transferring from the old 3 room surgicenter, to the new 5 room surgical suite. This required performing cases on Friday July 16 in the old surgicenter, moving all the equipment and supplies over the weekend, and opening the new surgical suite on Monday July 19. This involved an incredible amount of planning, coordination, and work by our surgicenter staff and went off without a hitch.
Surgical suite staff Debi Simonton Surgical Tech (ST), Arlinx Benjamin (ST), Jamie Sheehan (ST)
Please feel free to visit us if you are in Boston!
Joseph Bayes M.D.
Director of Preoperative Evaluation
Department of Anesthesia
Massachusetts Eye and Ear Infirmary
243 Charles Street
Boston, MA 02114
Joseph_bayes@meei.harvard.edu
617 573 3380