2. Awakening from Anesthesia
• Many factors influence the time of awakening
from anesthesia including patient factors, drug
factors, anesthetic agents used and time of
surgery.
• Consider reversible electrolyte problems for
delayed emergence of consicousness
• Treat and Prevent Hypothermia which is
common
3. Post Operative Extubation
• Early SBT may be appropriate in patients who
are awake and have no underlying cardiac
and/or pulmonary issues
• Early extubation reduces the risk of
pneumonia
4. DVT Prevention
• Post Operative patients are at high risk for
DVT
• LMWH is usually the best option for DVT
prophylaxis, although mechanical
compression devices are possibly effective
5. Nutrition
• The goal is enteral nutrition within 72 hours
for most patients.
• Trauma patients may benefit from earlier
nutrition
• TPN is rarely necessary
• Gastric or Post Pyloric feeding seems
equivalent in most cases. Gastric residuals of
300 cc are tolerated if there is not severe
abdominal distention or vomiting
6. Drains
• Each drain has a purpose. Changes in flow or
character of secretions may be important
• Passive (Penrose) and Active
(Hemovac, Woundvac(
7. Wound Care
• Primary Closure
• Secondary Intention healing with wet to dry
• Vacuum devices
8. Post Operative Hemmorhage
• Shock after trauma or surgery should always
assumed first to be due to hemmorhage.
• Initial Hb/Hct may not be helpful
• Get help
