PS04 2018: Post-anaesthesia care unit

 

List:

·        Patient care

·        Equipment

·        Design

 

Patient care:

General

·      Direct supervision of patients

·      1) Safety 2) Privacy

Protocols

·      Checking drugs

·      Checking equipment

·      Managing the standard patient

·      Managing common complications

·      Discharge criteria

Staffing

·      Nurse in charge + trained staff

·      2:1 if complex

·      1:1 standard

·      1:2 if simple (awake + stable)

Observations

·      Vital signs

·      Conscious state

·      Urine output

·      Dressings and drains

·      Special obs: neuro, vascular

Discharge criteria

First stage:

·      Medically stable (ABCD, temperature)

·      Symptoms controlled (pain, nausea)

·      No surgical complications (bleeding)

Second stage:

·      Medical (ABCD, wounds, symptoms ok)

·      Personal (can eat, drink, toilet, walk)

·      Instructions (wounds, meds, diet, mobility, follow up)

·      Logistics (companion to take home, phone access, <1hr from hospital)

 

Equipment:

Bedside

·      Oxygen

·      Suction

·      Power

·      Lights

·      Monitoring

·      Bag-mask 1:2

Airway

·      Standard equipment present

·      Difficult equipment available

·      Ventilator

Circulation

·      Vascular access

·      Fluids

·      Defibrillator

Drugs

·      Emergency

·      Intubation

·      Emergency

·      Reversal

·      Analgesics

·      Anti-emetics

Monitoring

·      Standard

·      Capno

·      ABP and CVP

·      NMT

Diagnostics

·      Glucose and ketones

·      Blood gas

·      Diagnostic imaging available

Other

·      Air and fluid warmers

·      Surgical tray

·      Warming cupboard

·      Refrigerator

 

Design:

Unit

·      Close to OR

·      Easy entry and exit

·      Easy passage within

·      Emergency call system

·      Large enough for peak hours

·      Separate area for paeds, obstetrics

Bay

·      Space

·      Lighting

Bed

·      Firm

·      Tilt bed and head

·      Wheels

·      Brakes

·      Rails

·      Poles

 

 

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