When planning care for a patient in the post anesthesia care unit the nurse should first assess the clients?

Division of General Surgery/Critical Care/Periop Services Anesthesia

Introduction
Frequently Asked Questions (FAQ)
PACU Staff

12-09-2010 Introduction

Having surgery can be a frightening and confusing time and its normal to have questions or concerns regarding your care. When your procedure is complete you want to continue to receive the same careful and specialized care during your recovery. This is the responsibility of the Post Anesthesia Care Unit. The goal of this web site is to help prepare you for what you can expect following your surgery as Stony Brook University Hospital, answer some of the more commons questions you might have and to provide you additional resources should you feel you need more information.

The Post Anesthesia Care Unit (or PACU for short) is staffed by a team of Nurses, Anesthesiologists and support services who are specifically trained to deal with the unique needs of the post surgical patient. When you first arrive in the PACU your nurse receives an account of your surgery as well as your current and past medical history from your anesthesiologist and operating room (OR) nurse. You'll be given a physical assessment and monitors such as a blood pressure cuff, EKG and pulse oximeter to monitor your vital signs. More extensive procedures may require additional monitors if your physician feels they're necessary. Your dressings (bandages) will be checked, pain control administered if necessary and any concerns you have addressed.

When its time to leave the PACU your nurse will give a report covering the details of your stay to the next nurse who will be taking care of you. Depending upon your surgery and previous arrangements you'll either be taken to a room or back to Pre-Surgical Admissions for additional instructions prior to your discharge home.

Frequently Asked Questions (FAQ)

1. What is PACU?

PACU stands for Post Anesthesia Care Unit. It is the unit where patients are temporarily admitted after any surgical; procedures. It'is a vital part of hospitals and other medical facilities. It is normally attached to operating room suites, designed to provide care for patients recovering from anesthesia, whether it be general anesthesia, local or regional anesthesia such as epidurals and spinals.

2. What do I need to tell my Nurse?

The nurses in the PACU are skilled in the care of post surgical patients and they will have been given a detailed history when you first arrive. You should tell the nurse if you are experiencing pain. You'll be asked to rate your pain on a scale of 0 to 10, 0 meaning no pain and 10 the worst pain. The nurse will reassess your pain level frequently as they work to make you as comfortable as possible. Some people may develop nausea after surgery. You should tell this to your nurse as soon as possible so it can be treated with appropriate medications.

3. What should I be feeling after my surgery?

While some discomfort may be expected after your procedure every effort will be taken to make your stay as comfortable and pleasant as possible. As previously mentioned you should tell your nurse if you are experiencing pain. There are many ways in which your pain can be managed. Your anesthesiologist and surgeon will discuss these with you prior to your procedure. Its possible that you may feel sleepy, dizzy or forgetful. Communication is the cornerstone of quality health care. As such you should talk with the nurse or anesthesiologist if something is concerning to you.

4. When will I see my family after surgery?

Visitation in the PACU is at the discretion of the nurse and physician caring for you a varies depending upon your procedure. You should discuss this with the nursing staff.

5. How long will I stay in the PACU?

The length of your PACU stay is dependent on a number of factors: the type of surgery, your particular medical needs and the judgment of your physicians. Some conditions such as Obstructive Sleep Apnea or administration of certain medications may require additional monitoring before you are deemed appropriate for discharge from the PACU.

In some cases it may be necessary to keep you asleep for a while when the surgery is complete. When this happens we will keep you comfortable and continue to monitor you during your stay.

Occasionally there will be times when a patient has to wait for their room to be ready following their surgery. When this happens the patient stays in the PACU. They are still followed by their primary team and cared for by the nursing team until their room becomes available.

6. Will there be issues if I have a device such as a CPAP or AICD?

If you brought your CPAP or BiPA, insulin pump or pain pump they will go with you when you leave the PACU. If you have an implanted device such as an Automated Internal Cardiac Defibrillator (AICD) or Deep Brain Stimulator (DBS) which was deactivated prior to your procedure it will be reactivated by the appropriate service before you leave the PACU.

7. What do I need to know before going home?

If you are going home that same day you will be given printed discharge instructions for your care at home. The nursing staff will review these instructions with you and a family member or friend. Your instructions will include any restrictions on activity, diet, pain medications, a follow-up with your surgeon if necessary and any signs to watch for and to report to your surgeon if necessary.

8. Can I see my Family members while I am in the PACU?

Yes. Once the nurse taking care of you is happy with your vital signs and other post surgical requirements, he or she will contact the waiting area and will let your family member see you.

9. Will you give me prescription for pain medications?

The Anesthesiologist will put in orders for giving you adequate amount of medications through your existing IV for controlling your pain. Under some circumstances the Anesthesiologist, will also be able to give you medications to take by mouth too. The take home prescriptions are usually given by the Surgical Team.

10. After my last surgery I had severe nausea and vomiting. Can this be prevented?

The answer is yes. Generally speaking, your Anesthesiologist will be giving you anti-emetics in the operating room. However so, if you are still experiencing nausea in the PACU, we will try to administer a different anti-emetics. Also keep in mind that different individuals have different susceptibility to anti-emetics. Majority of the times, the anti-emetics will be effective.

11. Where do I go from the PACU?

It depends on the type of procedure, duration of procedure and bed availabilities.

Staff

Thomas Corrado, M.D.
Shaji Poovathoor, M.D.

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