10. Since protective reflexes may still be compromised,
steps should be taken to protect the patient from:
traumatic injury (especially to limbs and neck) during transfer
from operating table to bed
airway
hypoxia
accidental disconnection or removal of drains and lines.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
11. The design of transfer stretcher
oxygen cylinders, masks and tubing
protective "sides"
provision of clamps for drainage tubes
equipment to secure and support the airway
infusion poles.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
12. Staff injury: Staff injury during lifting procedures is common
"lifting" policy, inc luding any specified role for doctors
means for calling assistance
devices for assisting patient transfer e.g. "Pat Slide".
พว.ณิชาภา ปฐมสิทธาภิรักษ์
13. Hand-over
A completed anesthetic record must be made available to the
staff with details of the surgery
Specific verbal and written instructions for post-operative care
should be given.
Drug and fluid regimens must be written on the appropriate
charts.
A full and formal hand - over should take place on arrival in PACU
พว.ณิชาภา ปฐมสิทธาภิรักษ์
14. Staffing and equipment levels
One-to-one staffing is required at least until the patient is
Conscious and able to maintain a clear airway .
พว.ณิชาภา ปฐมสิทธาภิรักษ์
15. Observations and record keeping
Each patient must be kept under continuous clinical observation .
Physiological parameters should be measured and recorded at
regular intervals
พว.ณิชาภา ปฐมสิทธาภิรักษ์
16. Use of controlled drugs
Administration of opioid analgesics by recovery staff should be
subject to local protocols. Staff should be aware of the potential
synergistic effects of different analgesic methods.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
17. Transfer from PACU
A formal checklist should be established for staff to satisfy
themselves that a patient is fit to be discharged from PACU
พว.ณิชาภา ปฐมสิทธาภิรักษ์
18. Transfer from PACU to ward
Documentation to accompany the patient should include
Instructions for:
supplemental oxygen
fluid replacement
analgesic and anti-emetic regimens
monitoring, if this differs from the normal practice of the
receiving ward
พว.ณิชาภา ปฐมสิทธาภิรักษ์
19. Transfer from PACU to ICU
The receiving unit must first be advised of:
the imminent arrival of the patient
the level of equipment which will be required to manage the
patient
settings for ventilatory support
drugs required.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
20. Transfer from PACU to ICU
Monitoring and infusion equipment used for transfer must have:
fully charged batteries
a capacity to measure and control an appropriate range of
physiological parameters.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
21. Post-operative pain management
Staff required to look after patients receiving continuous epidural
or other regional blockade
Drug prescription charts should be reviewed and annotated to
highlight the administration of neuraxial opioid infusions and
help eliminate the risk of unintentional, simultaneous
administration of opioids by other routes.
พว.ณิชาภา ปฐมสิทธาภิรักษ์
22. Discharge home
Patients to be discharged hom e directly from PACU require
Special arrangements to ensure an adequate level of after-care .
พว.ณิชาภา ปฐมสิทธาภิรักษ์
