{"id":679,"date":"2022-12-08T14:04:28","date_gmt":"2022-12-08T14:04:28","guid":{"rendered":"https:\/\/perioperative1001.slc-courses.ca\/?p=679"},"modified":"2022-12-15T19:21:18","modified_gmt":"2022-12-15T19:21:18","slug":"module-10-c-post-anesthesia-care-unit-pacu-ongoing-assessment","status":"publish","type":"post","link":"https:\/\/perioperative1001.slc-courses.ca\/?p=679","title":{"rendered":"Module 10: C. Complications in Post Anesthesia Care Unit (PACU)"},"content":{"rendered":"\n<h2>Complications in Post Anesthesia Care Unit (PACU)<\/h2>\n\n\n\n<p><strong>Management starts in the OR and continues to PACU<\/strong>:<\/p>\n\n\n\n<ol><li>NSAIDs<\/li><li>Opioids (Fentanyl, Morphine, Dilaudid)<\/li><li>Anxiolysis (Benzodiazepines)<\/li><li>Regional anesthesia (epidural, spinal, peripheral nerve blocks)<\/li><li>PCA<\/li><\/ol>\n\n\n\n<p>(Odem-Forren, 2019)<\/p>\n\n\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-42\" class=\"h5p-iframe\" data-content-id=\"42\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Module 10: Complications in Post Anesthesia Care Unit (PACU)\"><\/iframe><\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h5>PACU Discharge Criteria<\/h5>\n\n\n\n<ul><li>The <a id=\"post-531-_Int_Zh7ItTBI\"><\/a>Aldrete score is used to assess readiness for discharge. It evaluates activity, respiratory, circulation, consciousness, and oxygen saturation.<\/li><li>Patients are ready for discharge <a id=\"post-531-_Int_AeDKK8y3\"><\/a>when vital signs are stable, they have recovered from anesthesia, and there are no presenting complications.<\/li><li>The Aldrete score must be 8\/10 before discharge or follow the hospital policy.<\/li><li>Post op nausea and vomiting delays discharge from PACU because this increases the incidence of aspiration. <ul><li>Prevention includes responding immediately to complaints of nausea and vomiting.<\/li><li>It also includes avoiding conversations and rapid movements. Elevating the head can prevent post op nausea and vomiting. <\/li><\/ul><\/li><\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table><thead><tr><th>Parameters<\/th><th>Description of the Patient<\/th><th>Score<\/th><\/tr><\/thead><tbody><tr><td>Activity Level<\/td><td>Moves all extremities voluntarily\/on command<br>Moves 2 extremities <br>Cannot move extremities<\/td><td>2<br>1<br>0<\/td><\/tr><tr><td>Respiration<\/td><td>Breathes deeply and coughs freely<br>Is dyspneic, with shallow, limited breathing<br>Is apneic<\/td><td>2<br>1<br>0<\/td><\/tr><tr><td>Circulation (Blood Pressure)<\/td><td>Is 20 mmHg > Preanesthetic level<br>Is 20 to 50 mmHg > Preanesthetic level<br>Is 50 mmHg > Preanesthetic level<\/td><td>2<br>1<br>0<\/td><\/tr><tr><td>Consciousness<\/td><td>Is fully awake<br>Is arousable on calling<br>Is not responding<\/td><td>2<br>1<br>0<\/td><\/tr><tr><td>Oxygen Saturation as Determined by Pulse Oximetry<\/td><td>Has a level > 90% when the breathing room air<br>Requires supplemental oxygen to maintain 90%<br>Has level &lt; 90% with supplemental oxygen<\/td><td>2<br>1<br>0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>(Odem-Forren, 2019)<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h5>\ud83e\udde0 Graded Activity<\/h5>\n\n\n\n<p>In Blackboard, complete the <strong>Graded Activity: Case Study<\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h5>Summary<\/h5>\n\n\n\n<p>The debriefing phase of the SSC allows for the interprofessional team to discuss post-op plans for the patient, outline any issues or challenges that occurred intraoperatively, and discuss follow-up. Also, it provides room to discuss what went well. It is the final communication between the team about the patient, to minimize untoward events and improve patient outcomes. Communication plays a vital role in safe care. Therefore, it is important that the perioperative RN provides a thorough transfer of care to the PACU RN. The information provided by the perioperative team will assist the PACU <a id=\"post-531-_Int_qJjFsWVy\"><\/a>RN in assessing and monitoring the patient postoperatively.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Complications in Post Anesthesia Care Unit (PACU) Management starts in the OR and continues to PACU: NSAIDs Opioids (Fentanyl, Morphine, Dilaudid) Anxiolysis (Benzodiazepines) Regional anesthesia (epidural, spinal, peripheral nerve blocks) PCA (Odem-Forren, 2019) PACU Discharge Criteria The Aldrete score is used to assess readiness for discharge. It evaluates activity, respiratory, circulation, consciousness, and oxygen saturation. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"templates\/template-content.php","format":"standard","meta":[],"categories":[25],"tags":[],"wf_post_folders":[24],"_links":{"self":[{"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/posts\/679"}],"collection":[{"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=679"}],"version-history":[{"count":3,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/posts\/679\/revisions"}],"predecessor-version":[{"id":880,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=\/wp\/v2\/posts\/679\/revisions\/880"}],"wp:attachment":[{"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=679"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=679"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=679"},{"taxonomy":"wf_post_folders","embeddable":true,"href":"https:\/\/perioperative1001.slc-courses.ca\/index.php?rest_route=%2Fwp%2Fv2%2Fwf_post_folders&post=679"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}