Ether Resources for Anesthesia Research and Education

Stanford PACU Rotation Educational Site

Please note, the PACU rotation has been significantly reorganized this year. The following is a basic outline of daily and weekly activities for the rotation. Refer to the PACU syllabus for complete goals and objectives and didactic materials. Over the coming year, changes may be made to the rotation as needed, thus this handbook may not be completely up to date for PACU.

 

7:00-8:00 AM    Directed reading time in PACU.  Refer to syllabus for materials

 

8:00 AM-6:00 PM

 

 

GUIDELINES FOR EPIDURAL MANAGEMENT

 

In PACU:

 

• Start infusion only after assessing pt.status.(no instabilities, contraindications, motor block, or high block)

• Determine your level of confidence that the catheter is functional.

  • MD report is helpful, depth?, was it tested?, Rx given intraop?

  • If no sensory level try 3-5 ml 2 % lidocaine

  • Draw back on catheter to check for blood,

  • Possible intravascular placement? use, w/ epi 1/200k w/ test dose), wait 10 min

  • Recheck level, if unilateral try pulling back 1-2 cm.

• If all fails, consider replacing the catheter

Do not send non-functional catheter to floor

• If necessary d/c it and replace or start PCA.

• If catheter ok, and pt. does not have motor block, determine level + start infusion.

• Please refer to the document: PACU Pain Guidelines document

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