Questions swirl around procedure that led to Joan Rivers' death
As an investigation is launched, questions remain about the circumstances leading to Joan Rivers’ death.
The tragedy began when Rivers, 81, lost consciousness at an outpatient surgery clinic in New York during a vocal cord procedure and was then rushed to Mount Sinai Hospital for emergency care.
While it might take some time before the public knows more about what happened, Yahoo Health checked in with some experts regarding protocol for treating elderly outpatients in settings such as Yorkville Endoscopy, where Rivers had her ill-fated procedure (and which could not be reached for comment).
And, surprisingly, age is not the most important factor when assessing risks.
“With the elderly—unlike with kids—there aren’t specific milestones at specific ages,” Dr. John Abenstein, president-elect of the American Society of Anesthesiologists, told Yahoo Health.
“I can have a 50-year-old patient, for example, who is physiologically older than an 80-year-old.”
Abenstein, who practices anesthesiology, said he routinely takes care of patients 90 and older, and that doing so is common at outpatient centers across the country.
“It can be done safely under many circumstances,” he noted, adding that what’s most important is assessing a patient’s underlying health status, functional status, medical history, and the risk factors of the procedure itself.
One of the first questions he asks patients when deciding whether to move forward with a sedated procedure is if they can walk up two flights of stairs.
“If the answer is ‘yes,’ it’s most likely appropriate,” he said.
If the answer is “no,” he dives deeper to uncover why, to find out if it’s because of arthritis, for example, or a cardiovascular issue, which could be a red flag.
“Cardiopulmonary function is what we concentrate most on,” he added. "That’s because the highest risk with anesthesia in general"
The deeper one is put under, the harder it is to breathe and protect oneself with reflexes (the gag reflex, for example).
