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INTRODUCTION

American Society of Anesthesiology (ASA) Task Force published the practice guideline for postanesthetic care in 2002.1 The purpose of these guidelines is to improve postanesthetic care outcomes for patients who have just had anesthesia and analgesia care.

General medical supervision and coordination of patient care in the postanesthetic care unit (PACU) should be the responsibility of anesthesiologists (ASA Standard IV).2 The communication guidelines have been developed to improve coordinated patient care during response to urgencies/emergencies in the PACU in Labor and Delivery Unit at Beth Israel Deaconess Medical Center (BIDMC). These guidelines are modified to meet the needs of the specific patient population, obstetric patients, and to exceed the ASA Standards IV for postanesthesia care.

The goals for the BIDMC guidelines are specific to:

  • Encourage high-quality patient care in the PACU.

  • Promote multiple teams’ collaboration.

  • Ensure effective communication between healthcare professionals.

  • Share information and share appropriate responsibility.

BIDMC PACU care pathways include:

FIGURE 53-1

PACU nursing communication pathways.

Source: Reproduced with permission from CP-OB 45 PACU Nursing Notification, 2007. © Beth Israel Deaconess Medical Center. Accessed April 2022.

CNS, central nerve system; DBP, diastolic blood pressure; MEWS, maternal early warning system; RR, respiratory rate; RUQ, right upper quadrant; SBP, systolic blood pressure.

FIGURE 53-2

BIDMC PACU handoff.

Source: Reproduced with permission from CP-OB 57 PACU Nursing Handoff, 2021. © Beth Israel Deaconess Medical Center. Accessed April 2022.

FIGURE 53-3

BIDMC postanesthesia note.

Source: Reproduced with permission from Talis. PACU Post Anesthesia Note. © Beth Israel Deaconess Medical Center. Accessed April 2022.

REFERENCES

1. +
American Society of Anesthesiologists. Practice guidelines for postanesthetic care. A report by the American Society of Anesthesiology Task Force on Postanesthetic Care. Anesthesiology. 2002;96:742–752.  [PubMed: 11873052]
2. +
American Society of Anesthesiologists. Standards for postanesthesia care. Last amended October 23, 2019. https://www.asahq.org/standards-and-guidelines/standards-for-postanesthesia-care.
3. +
Beth Israel Deaconess Medical Center PPGD©. CP-OB 45 PACU Nursing Notification, 2007. Accessed April 2022.
4. +
Beth Israel Deaconess Medical Center PPGD©. CP-OB 57 PACU Nursing Handoff, 2021. Accessed April 2022.

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