Post Anesthesia Care Unit (pacu) Mahasiswa.ppt 2y3s5f

Post Anesthesia Care Unit (PACU)

INTRODUCTION • Centralization of this care in the form of recovery rooms called Postanesthesia Care Unit (PACU) • Guidelines : The ASA House of Delegates Standards for Postanesthesia Care Oct 12, 1988 • Last amended on October 27, 2004

• Located near the operating rooms • Construction guidelines a min 7 feet (2 m) beetwen beds and 120 square feet/patient (10m2) • Multiple electrical outlets, one oxygen, air, suction each space • Monitor: SpO2, ECG, NIBP, desirable but not mandatory • Forced air warming device, heating lamps, warming blanket

• Staffing • Medical direction: Anesthesiologist • 1 Nurse for 2 patients 2 Nurse for 1 patient if requires continuos nursing care Expertise in airway management & ACLS

• Average PACU stay is 1 h

• Routine Recovery – Pain control: • NSAIDs (ketorolac, Ketoprofen) • Opioids (Meperidine 10-50mg IV, Fentanyl 25 mcg IV, Tramadol 50mg IV, Morphine 2-4mg)

– Agitation: • Midazolam 1mg IV, Fentanyl 25mcg IV

– Nausea & Vomiting: • Metoclopramide 0.15mg/kg IV • 5-HT3 receptor : Ondansetron 4mg IV add dexamethasone 5mg IV

– Shivering: Meperidine (Pethidine) 25mg IV

• Discharge Criteria – Easy arousability – Full orientation – The ability to maintain and protect the airway – Stable vital signs at least 15-30 min – The ability to call for help if necessary – No obvious surgical complications (active bleeding)