Post-anesthesia care unit
A post-anesthesia care unit, often abbreviated PACU and sometimes referred to as post-anesthesia recovery or PAR, is a vital part of hospitals, ambulatory care centers, and other medical facilities. It is an area, normally attached to operating theater suites, designed to provide care for patients recovering from anesthesia, whether it be general anesthesia, regional anesthesia, or local anesthesia.
Common activities
The PACU staff (commonly called recovery) is generally composed of highly trained staff who are charged with many vital tasks for the care of post-anesthesia and post-operative patients. These essential activities include:-
- airway management and oxygen administration for those who have undergone a general anaesthetic
- monitoring vital signs (heart rate, blood pressure, temperature and respiratory rate)
- managing post-operative pain
- treating symptoms of postoperative nausea and vomiting (or PONV)
- treating postanesthetic shivering
- monitoring surgical site(s) for excessive bleeding, mucopurulent discharge, swelling, hematoma, wound healing, redness, etc.
These common activities may often need supplementing with more intensive care or treatment. This may require :
- Preparation and education for the use of Patient Controlled Analgesia (PCA) units
- Preparation and establishment of IV, epidural or perineural infusions
- Preparation and establishment of invasive monitoring such as arterial lines, central venous lines, ventriculostomies, etc.
Post-operative complications
Occasionally, serious life-threatening complications, such as laryngospasm, respiratory arrest, or malignant hyperthermia can arise post-anesthesia. Patients are cared for with interdisciplinary measures from Anesthesiologists, Certified Anesthesiologist Assistants or CAA's, Certified Nurse Anesthetists or CRNA's, PACU nurses and Surgeons. Patients may remain or have to be re-intubated due to anaphylaxis, pulmonary edema, pneumothorax, or complications from surgery such as extended operative time and long-term exposure to anesthesia and narcotics. Unless complications occur, most patients will only stay in the PACU for a few hours, then return to same day surgery unit before returning home or to another department of the hospital.
There is the potential for other serious complications due to relatively easy-to-prevent situations such as patient slips and falls while coming off surgery anaesthesia in recovery rooms.
See also
- Anesthesia
- Intensive Care Unit
- Nurse anesthetist
- Operating department practitioner
- Anesthetic technician
- Aldrete's scoring system
External links
- Ketamine: Emergency Applications (eMedicine.com) - discusses laryngospasm.