The roles of the PACU nurse include monitoring patients recovering from anesthesia for complications and ensuring safe recovery. PACU nurses must be skilled in airway management, resuscitation, and caring for surgical drains and catheters. Key responsibilities involve assessing vital signs, pain, nausea and other physiological parameters regularly and providing interventions to address issues like hypoxemia and pain. Discharge criteria involves patients being awake, stable, and without active issues like bleeding or hypothermia before leaving the PACU.
Post anesthesia care unit or , High Dependency unit is part of hospital for Post surgery/procedures recovery.Nursing, anesthesiologist, surgeons, hospital administration need to know about ideal conditions.
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Post anesthesia care unit or , High Dependency unit is part of hospital for Post surgery/procedures recovery.Nursing, anesthesiologist, surgeons, hospital administration need to know about ideal conditions.
The post operative period begins from the time the patient leaves the operating room and ends with the follow up visit by the surgeon. The post operative care is provided by – PACU
Things to ensure and check off the list before a patient is shifted to the OR for surgery. The responsibility rests mainly with the resident doctor and the registered nurse to ensure complete preoperative preparation of the patient.
Post Operative Care | PACU | Complications | Treatment Yashasvi Verma
Post operative period is the most crucial and
critical span of time after completion of surgery
In this period numerous complications occur and if not treated on time can prove fatal hence increasing the mortality rate .
The specialized care provided to the patient after completion of surgery till the patient is fully conscious
This specialized care is provided in a specialized area called PACU
SEVERAL POST OPERATIVE COMPLICATIONS LIKE
HYPOXIA , HYPERTENSION , HYPOTENTION , HYPO THERMIA , HYPERTHERMIA , MODIFIED ALDERT SCORE , PAIN ASSESMENT AND TREATMENT , POST OPERATIVE NAUSEA AND VOMITING , ETC. MIGHT OCCUR .
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
Regional anesthesia is anesthesia affecting only a specific area of the body when the patient is conscious, e.g. foot, arm, lower extremities, insensate to stimulus of surgery or other instrumentation.
Central Venous Catheter Care- A Nursing skill Tse Sona
- Shared on the request of al the delegates who attended and those who couldn't attend the webinar on "CVC care- A Nursing Skill'' due to limited seats. I hope it will be helpful to all
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Things to ensure and check off the list before a patient is shifted to the OR for surgery. The responsibility rests mainly with the resident doctor and the registered nurse to ensure complete preoperative preparation of the patient.
Post Operative Care | PACU | Complications | Treatment Yashasvi Verma
Post operative period is the most crucial and
critical span of time after completion of surgery
In this period numerous complications occur and if not treated on time can prove fatal hence increasing the mortality rate .
The specialized care provided to the patient after completion of surgery till the patient is fully conscious
This specialized care is provided in a specialized area called PACU
SEVERAL POST OPERATIVE COMPLICATIONS LIKE
HYPOXIA , HYPERTENSION , HYPOTENTION , HYPO THERMIA , HYPERTHERMIA , MODIFIED ALDERT SCORE , PAIN ASSESMENT AND TREATMENT , POST OPERATIVE NAUSEA AND VOMITING , ETC. MIGHT OCCUR .
Post-Operative Managment
• The post operative period begins from the time
• The patients leaves the operating room and ends with the
follow up visit by the surgeon.
• The post operative care is provided by
-- PACU
-- SICU
A "bundle" is a
group of evidence-based care components
for a given disease that, when executed together, may result in better outcomes than if implemented individually.
Regional anesthesia is anesthesia affecting only a specific area of the body when the patient is conscious, e.g. foot, arm, lower extremities, insensate to stimulus of surgery or other instrumentation.
Central Venous Catheter Care- A Nursing skill Tse Sona
- Shared on the request of al the delegates who attended and those who couldn't attend the webinar on "CVC care- A Nursing Skill'' due to limited seats. I hope it will be helpful to all
The CVP catheter is an important tool used to assess right ventricular function and systemic fluid status. Normal CVP is 2-6 mm Hg. CVP is elevated by : overhydration which increases venous return.
Management Of Patient Undergoing Surgerykalyan kumar
Preoperative care refers to health care provided before a surgical operation. The aim of preoperative care is to do whatever is right to increase the success of the surgery.
At some point before the operation the health care provider will assess the fitness of the person to have surgery.
During the perioperative period, specialised nursing care is needed during each phase of treatment. For nurses to give effective and competent care, they need to understand the full perioperative experience for the patient.
Perioperative refers to the three phases of surgery.
Preoperative stage
Intraoperative stage
Postoperative stage
Within these stages there are many different roles for nurses and different care needed for the patient dependent on which stage they are in.
As with any nursing care, the goal during these stages is to provide holistic and evidence based care as well as support to the individual.
There are different nursing roles throughout the perioperative process including: admissions nurse, anaesthetic nurse, circulating nurse or scout nurse, instrument or scrub nurse, post anaesthesia care unit (PACU) nurse and the surgical ward nurse. Other nurses may be included in the perioperative process such as pain management specialist nurses, diabetes educators.
A Postanesthesia Care Unit (PACU) or an area which provides equivalent postanesthesia care. shall be available to receive patients after anesthesia care. PACU and sometimes referred to as post-anesthesia recovery or PAR, or simply Recovery is a vital part of hospitals, ambulatory care centers, and other medical facilities.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
1. ROLES OF THE POSTANESTHESIA CARE UNIT NURSE Nicanor I. Alfaro Jr. R.N. Head Nurse Postanesthesia Care Unit UP-PGH
2. PACU Recovery from anesthesia can range from completely uncomplicated to life-threatening. Must be managed by skilled medical and nursing personnel. Anesthesiologist plays a key role in optimizing safe recovery from anesthesia.
3. History of the PACU Methods of anesthesia have been available for more than 160 years, the PACU has only been common for the past 50 years. 1920’s and 30’s: several PACU’s opened in the US and abroad. It was not until after WW II that the number of PACU’s increased significantly. This was due to the shortage of nurses in the US. In 1947 a study was released which showed that over an 11 year period, nearly half of the deaths that occurred during the first 24 hours after surgery were preventable. 1949: having a PACU was considered a standard of care.
4. PACU Location Should be located close to the operating suite. Immediate access to x-ray, blood bank, blood gas and clinical labs. Should have 1.5 PACU beds per operating room used. An open ward is optimal for patient observation, with at least one isolation room. Central nursing station. Piped in oxygen, air, and vacuum for suction. Requires good ventilation, because the exposure to waste anesthetic gases may be hazardous
5.
6. PACU Standards 1. All patients who have received general anesthesia, regional anesthesia, or monitored anesthesia care should receive postanesthesia management. 2. The patient should be transported to the PACU by a member of the anesthesia care team that is knowledgeable about the patient’s condition. 3. Upon arrival in the PACU, the patient should be re-evaluated and a verbal report should be provided to the nurse. 4. The patient shall be evaluated continually in the PACU. 5. A physician is responsible for discharge of the patient.
7. The PACU nursebasic training requirements Airway management Basic life support Advanced cardiac life support (Morgan et al., 2006) Caring for acute surgical wounds Caring for a variety of drainage catheters
8. Nurse-to-patient ratios 1:1 initial 15 minutes, as the patient emerge from anesthesia, overflow from an ICU, unstable and requiring transfer to ICU 2:1 critically ill, unstable, complicated problems, newly admitted, on mechanical ventilator with an artificial airway
9. 1:2 one patient CSU (conscious, stable, and uncomplicated) and the other unconscious, but stable and uncomplicated 1:3 to 1:6 all CSU and being considered for discharge Nurse-to-patient ratios
10. Equipments needed The unit needs a full complement of airway equipment , including oxygen masks and cannulas, oral and nasal airways and tubes, tracheostomy tubes, airway scopes and ventilation bags, chest tube trays, ventilators aerosol treatment cardiac equipments such as defibrillator, pacing devices, ECG equipment, vascular cutdown trays infusion pumps, advanced life-support crash cart and a complete stock of cardiopulmonary rescue drugs.
11. Routine monitoring After general anesthesia, most patients take 15-30 minutes to become fully awake, to be breathing normally and to be physiologically stable Until a patient is awake and stable, vital signs and blood oxygenation saturation are recorded every 5 minutes. Subsequently, blood pressure, pulse rate, and respiratory rate are measured every 15 minutes Temperature is measured and recorded at least once early in the PACU stay.
12. Depending on the patient, other physiologic parameters that might be monitored regularly are: Pain Nausea Bleeding Drainage/catheters Fluid intake and output Central venous pressure Intracranial pressure
13. Oxygen supplementation All patients recovering from general anesthesia should receive 30-40% oxygen during their emergence Certain patients have a greater than normal risk of developing hypoxemia and may need supplemental oxygen during their entire stay in the PACU. These include Older adults Patients with pre-existing lung problems Thoracic or upper abdominal surgery
14. Recovery from Anesthesia The PACU team’s aim is for patients to emerge gradually from anesthesia The goal is to recognize and quickly correct airway obstruction, peaks or troughs in blood pressure, decreases in blood oxygenation, temperature changes and delirium to temper any sudden changes in physiology, to minimize pain, nausea or vomiting, and
15. Characteristics of the patient and the surgery can also prolong the time needed for recovery DURATION OF SURGERY VENTILATION ABILITY PRE-EXISTING MEDICAL PROBLEMS
16. Duration of surgery Longer surgeries build higher concentrations of anesthetic that is stored in tissues throughout the body Patients tend to recover more slowly from longer operations
17. Ventilation ability Gaseous anesthetics are released from the body through the lungs Postoperative patients with poor ventilation take longer to reduce their anesthesia load and these patients require more recovery time
18. Pre-existing medical problems Patients with metabolic or excretory problems, such as liver disease or kidney disease tend to recover more slowly from anesthesia (Morgan et al., 2006)
21. MANAGEMENT OF PAIN(at PACU ) Assess and record pain and its characteristics: Location Frequency Quality Use pain assessment scale Administer analgesics to promote optimum pain relief
23. categorical scale or the simple descriptor scale A list of adjectives describing different levels of PAIN INTENSITY no pain mild pain moderate pain severe pain
24. Visual Analogue Scale (VAS) PAIN AS BAD AS IT COULD POSSIBLY BE NO PAIN ________________________ 10 cm (AHCPR 1994)
25. Faces Rating Scale Most commonly used is the : Wong-Baker Faces scale 0-5 or 0-10 scale with 6 facial expressions suggesting different pain intensities each face accompanied by a descriptor and number helpful for assessing persons with moderate to severe dementia who have lost much of their ability to use language to describe pain
26. Wong-Baker FACES Pain Rating Scale WHICH FACE SHOWS HOW MUCH HURT YOU HAVE RIGHT NOW ? 0 1 2 3 4 5 HURTS LITTLE MORE HURTS EVEN MORE HURTS WHOLE LOT HURTS WORST NO HURT HURTS A LITTLE BIT Adopted from Wong DL, Hockenberry-Eaton M. Wilson D. et.al.Whaley & Wong’s Nursing Care of Infants and Children. 6th ed. St. Louis, MO: Mosby-Year Book, Inc. 1999.
31. COMMON SIDE EFFECTS OF OPIOIDS RESPIRATORY DEPRESSION NAUSEA AND VOMITING SEDATION CONSTIPATION POTENTIAL TO PRODUCE TOLERANCE, DEPENDENCE AND ADDICTION
32. SIGNS AND SYMPTOMS OF NARCOTIC TOXICITY Unresponsiveness to physical stimulation Respiratory rate less than 7 per minute BRADYCARDIA Pinpoint pupils
33. NALOXONE A pure antagonist , used to counteract the effects of a narcotic overdose
34. Respiratory Complications Nearly two thirds of major anesthesia-related incidents may be respiratory. Airway obstruction Hypoxemia Low inspired concentration of oxygen Hypoventilation Areas of low ventilation-to-perfusion ratios Increased intrapulmonary right-to-left shunt
35. Do: Go to see the patient! Assess the patients vital signs and respiratory rate. Evaluate the airway. R/o obstruction or foreign body. Mask ventilate with ambu if necessary. Intubate and secure the airway. Look for causes of hypoxia. Send ABG, CBC, Get CXR. Respiratory Complications
36. Failure to Regain Consciousness Residual anesthetics: IV or inhaled Profound neuromuscular block Profound hypothermia Electrolyte abnormalities Thromboemboliccerebrovascular accident Seizure
37. Myocardial Ischemia Increased risk: History of CAD CHF Smoker HTN Tachycardia Severe hypoxemia Anemia Same risk if the patient has GA or regional anesthesia. Treatment Oxygen, ASA, NTG, and morphine if needed Consult cardiology
38. BLOOD SUGAR ABNORMALITIES Stress of surgery cortisol/glucagon dehydration/SSI Surgery can unmask type 2 diabetes in people with previously undetected disease, so all PACU patients should have their blood glucose levels checked at least once. patients liver disease glycogen hypoglycemia
39. Discharge from PACU A typical PACU stay is approximately an hour When a patient is transferred to a hospital care unit, the PACU nurse provides a comprehensive medical report to that unit. When the patient is being sent home, an adult must assume responsibility for the patient
40. Discharge criteria Unless the patient is going to an ICU, the patient who have had general anesthesia are not discharged from the PACU until he is: Awake and oriented Has clear airways, can breathe autonomously, and is maintaining a satisfactory level of blood oxygenation Has been physiologically stable with acceptable vital signs for 15-30 minutes
41. Is not hypothermic Is not actively bleeding Has controlled and tolerable levels of postoperative pain Is not vomiting (Aldrete, 1998; Smith & Hardy, 2007; Sherwood et al., 2008
42. All patients who have had regional anesthesia are not discharged until the sensory and motor blocks have worn off (Kiekkas et al., 2005; Morgan et al., 2006)
43. Discharge From the PACU Aldrete Score: Simple sum of numerical values assigned to activity, respiration, circulation, consciousness, and oxygen saturation. Postanesthesia Discharge Scoring System: Modification of the Aldrete score which also includes an assessment of pain, N/V, and surgical bleeding, in addition to vital signs and activity.
46. summary During their recovery from anesthesia, patients must be monitored until they are awake and their vital signs are stable. In an era of complex major surgeries done on increasingly compromised patients, emergence from anesthesia sometimes comes with life-threatening complications. For these reasons, recovery rooms, which were once postsurgical rest stations, are now short-term ICUs called postanesthesia care units, or PACUs.
47. PACU is staffed by nurses who are skilled in recognizing and managing airway problems, hypoxemia, hypotension, hypothermia, pain, nausea, and vomiting, as well as the lingering effects of anesthesia and muscle relaxants. PACU nurses must cope with bleeding from surgical sites, hypertension, dysrhythmias, myocardial infarctions, and altered mental states. The nurses carry out these specialized medical tasks in a setting where, at the same instant, there can be patients who are unconscious, emerging from sedation, suffering from acute respiratory or circulatory complications, being admitted, and being discharged.
48. Frederico A. (2007). Innovations in care: The nurse practitioner in the PACU. Journal of PeriAnesthesia Nursing 22(4): 235–42. American Society of PeriAnesthesia Nurses (ASPAN). (2003a). A position statement for medical-surgical overflow patients in the postanesthesia care unit (PACU) and ambulatory care unit (ACU). Retrieved May 2008 from http://www.aspan.org/PosStmts14.htm. American Society of Anesthesiologists (ASA). (2004). Standards for Postanesthesia Care. Retrieved March 2008 from http://www.asahq.org/publicationsAndServices/sgstoc.htm. Hockenberry MJ, Wilson D, Winkelstein ML: Wong's Essentials of Pediatric Nursing, ed. 7, St. Louis, 2005, p. 1259. Aldrete JA. (1998). Modifications to the postanesthesia score for use in ambulatory surgery. Journal of PeriAnesthesia Nursing 13(3): 148–55. References: