Stanford PACU Rotation Educational Site
INTRODUCTION
Dear PACU resident,
Welcome to the PACU rotation. We look forward to working with you over the upcoming rotation. This booklet contains information that will be helpful to you. Please review the PACU Goals and Objectives and Teaching Objectives early on in order to focus your learning.
We have included what we think are important learning objectives. Many of the topics are covered in the reading materials in this booklet including papers dealing with discharge criteria, and what patients experience during the week following ambulatory surgery. Some topics such as airway management are well covered in the standard texts. We think it is important to develop an approach to problems commonly encountered in the PACU just as you do in the OR. Residents in the past have not routinely managed problems in the PACU. We have learned more about PACU care as an attending than we did as a resident. However, this is an important aspect of the practice of anesthesia, especially in private practice where you can be responsible for patients in the PACU while involved in cases in the OR. Although you will be arriving at 7:30am in the PACU you may not see any PACU patients until a short while later. This time is meant to be utilized as reading time and self directed learning. Use this time to read over the journal articles provided to you in this booklet.
You will see a variety of PACU management issues. After you take report from the primary anesthesia team upon the patient's arrival to the PACU, you will be the physician responsible for all issues (i.e. PONV, CXR for line placement, hypotension, inadequate epidural pain relief) therefore you must be in the PACU and readily available outside of morning/lunch/afternoon breaks. You will be responsible for epidural orders and giving information about these patients to the Pain service, who will follow the patients on the wards.
Learning will be achieved in a variety of ways. To help ensure a solid foundation in PACU key concepts we ask that you review the Teaching Modules which can be found by clicking on the tab on the left. There are test questions to complete with each module. You are welcome to do one a day or so. Hopefully the modules will contain information that will allow you to think about PACU issues and do further reading on your own by either utilizing the black binder of papers or performing your own literature search.
During your professional career you will often find yourself giving in-service talks to educate the members of your perioperative anesthetic team. With this in mind, we ask that you prepare a 10 minute in-service talk on any topic for the PACU nurses to be given during the 2nd week.
During your rotation keep a log of all procedures performed. These can include placement of arterial lines, epidurals or peripheral nerve blocks to name a few. At the beginning of the rotation please be sure to look at the Self assessment form located on this website (look at the tab on the left). Please fill it out during your rotation and return it to me at the end of your rotation.
There is a tab on your left called PACU test questions. I ask that you send me your answers on the first day of the rotation. Please retake the test at the end of the rotation and I will then send you the answer key. Hopefully we will see an improvement in your score.
Please note that if you need help or support urgently, you should call the attending who was part of the patient's primary OR anesthesia team. If he/she is unavailable, then you can call the scheduler at x6-0249. After 5pm please sign out any ongoing issues to the 1st call attending. Please let us know early on about any problems you encounter. The sooner we know about them, the sooner we can help try and resolve them. We look forward to working with you!
SUMA RAMZAN, MD
Director of the PACU rotation
Clinical Assistant Professor
Stanford Hospital and Clinics
Department of Anesthesiology and Critical Care
email: sdramzan@gmail.com
pager: 23241
