The Post Anesthesia Care Unit Design and Resources

The Post Anesthesia Care Unit Design and Resources

The post anesthesia care unit (PACU) is designed and staffed to monitor and care for patients who are recovering from the immediate physiologic effects of anesthesia and surgery.

The PACU should be located near the operating rooms. A central location in the operating room area itself is desirable, as it ensures that the patient can be rushed back to surgery if needed or that members of the operating room staff can quickly attend patients.

Pulse oximetry (SpO2), electrocardiogram (ECG), and automated noninvasive blood pressure (NIBP) monitors for each space are desirable. However, all three monitors should be immediately available for every patient. Some PACUs monitor only SpO2 and NIBP for every patient in the initial phase of recovery from anesthesia; the ECG is used only for patients with a history of cardiac problems or who exhibit ECG abnormalities intraoperatively. Most PACU incidents leading to serious morbidity or mortality are related to inadequate monitoring. Capnography may be useful for intubated patients. Temperature must be monitored using mercury or electronic thermometers if an abnormality in temperature is suspected. A means of warming/ cooling devices should be available.

The PACU should have its own supplies of basic and emergency equipment, separate from that of the operating room. This includes oxygen cannula, a selection of masks, oral and nasal airways, laryngoscopes, endotracheal tubes, laryngeal mask, airways, and self-inflating bags for ventilation. The PACU should be staffed only by nurses specifically trained in the care of patients emerging from anesthesia.