Initial patient assessment on arrival to PACU (AIRWAY (Ensure the patient…
Initial patient assessment on arrival to PACU
-Oxygen & administration equipment
-PACU documentation records
Ensure the patient is breathing adequately
Is the airway clear and is their free and quiet exchange in and out of the chest
Attach pulse oximeter
If still unconscious, check oral airway / laryngeal mask are properly maintaining effective airway
Apply chin lift, jaw thrust if airflow is obstructed
If ETT tube in situ, suction prior to deflating cuff and removal
Suction as appropriate once the LMA is removed
Administer oxygen at 6L/min (3-4L for NP) for adults and or as prescribed by anaesthetist
Ensure chest/abdomen is rising and falling. Chest movement should be equal both sides
Assess air flow in and out of mouth
This can be assessed by looking for 'fogging' of the hudson mask or inflation and deflation of T-bag, re-breather reservoir.
Look for cyanosis
Saturation should be >95% on oxygen therapy, if lower a cause needs to be considered.
Obtain BP recording, pulse rate and rhythm from monitor and manually and record on document chart
Note any brady/tachycardia and hypo/hypertension and consider cause and action if required.
Observe patient perfusion
skin colour, mucous membrane colour, clammy/warm, capillary refill, vein fullness
Obtain temperature reading
Drugs, drips and drains
Note the medication given in theatre and any in pre-op
Specifically type of anaesthesia and analgesia that can affect respiratory
Check for allergies and ensure appropriate alert stickers are altered
Label and secure lines, complete relevant fluids running with fluid balance charting
Note IV therapy given in OT therapy, amount and type.
Check drains, type, and amount of drainage, and secure if needed.
Check urinary catheter is draining freely. Note colour, and amount of urine.
Check wound ooze and PV/PR loss if appropriate
Obtain a blood sugar if patient is diabetic
Connect PCA machine if required
Complete neurovasuclar observations of affected limbs
Elevate area of surgery if possible
Also position patient to maintain a safe and open airway.
Attach SCD device to patient