All patients having anesthesia at the MGH Orthopaedic ASC will be admitted to the PACU after their surgery. While in the PACU their vital signs will be monitored, pain management initiated, and fluids administered. The nurses in the PACU have extensive critical care experience and work under the direct supervision of the attending anesthesiologist.
The patient's length of stay in the PACU will vary from patient to patient. Discharge from the PACU to home will depend on meeting several criteria. First, the patient must demonstrate recovery from their anesthetic. Secondly, their vital signs must be stable. Sometimes after surgery patients require medicines to help control their heart rate, blood pressure, respirations, or other metabolic disorders, e.g. diabetes. These patients may require a little more time in the PACU until their vital signs are stable. Thirdly, their post-operative pain management will be initiated and their pain must be under control and manageable. Fourthly the patient should not be experiencing severe nausea and vomiting. Again, this may prolong their PACU stay, as they will be treated in the PACU with medication until it subsides. Lastly, when all the above criteria are met, the patient will be given a trial of drinking and eating a snack.
While the patient is in the PACU, the family member or the accompanying adult may have the option of filling the patient's prescriptions at our on site pharmacy. Visitation in the PACU is limited to avoid the risk of infection to other patients, to protect patient privacy, and to permit the PACU staff to concentrate on the care of all the post-surgical patients.
Once the patient has met discharge criteria the patient's intravenous will be removed and the patient will get dressed in preparation to leave. The patient and his/her accompanying responsible adult will then be given both verbal and written discharge instructions. The patient, either walking or in a wheelchair, will then be escorted by an ASC employee to the lobby and discharged to a responsible adult. The patient will also receive a post-op phone call from either a PACU nurse or an anesthesiologist the following day to check up on the patient's progress, pain control, and answer any questions he/she may have about his/her immediate post-op care.