5.2 Admission to Post Anesthesia Care Unit

  • Upon arrival in the unit, the anesthesia provider informs the PACU nurse of pertinent details on the patient's history, medical condition, anesthesia, and surgery.
  • Anesthetist should manage the patient until a PACU nurse secures admission vital signs and attaches appropriate monitors.
  • Document the time and amount of all neuromuscular relaxants, respiratory depressant medications, and reversal agents.
  • Never transfer responsibility to PACU personnel until the patient's airway status, ventilation, and hemodynamic are appropriate.
  • Check the function of indwelling cannula, intravenous catheters, and monitors before leaving.


Table 5.1 Components of a Post Anesthesia Care Unit Admission Report

Preoperative History
  • Medication allergies or reactions
  • Pertinent earlier surgical procedures
  • Underlying medical illness
  • Chronic medications
  • Acute problems (e.g., ischemia, dehydration)
  • Premedications
  • NPO status
Intraoperative Factors
  • Surgical procedure
  • Type of anesthetic
  • Relaxant/reversal status
  • Time and amount of opioids administered
  • Type and amount of intravenous fluids administered
  • Estimated blood loss
  • Urine output
  • Unexpected surgical or anesthetic events
  • Intraoperative vital sign ranges
  • Drugs given (e.g., steroids, diuretics, antibiotics, ...)
Assessment and Report of Current Status
  • Airway patency
  • Ventilatory adequacy
  • Level of consciousness
  • Level of pain
  • Heart rate and heart rhythm
  • Blood pressure
  • Intravascular volume status
  • Size and location of intravenous catheters
  • Overall impression
Postoperative Instructions in Collaboration With the Surgeon
  • Expected airway and ventilatory status
  • Acceptable vital sign ranges
  • Acceptable urine output and blood loss
  • Surgical instructions (e.g., positioning, wound care)
  • Anticipated cardiovascular problems
  • Orders for therapeutic interventions
  • Diagnostic tests to be secured
  • Therapeutic goals and end points before discharge
  • Location of responsible physician
Last modified: Thursday, 17 November 2016, 3:13 PM