CHAPTER 53

THE RECOVERY ROOM

Outline:

Principles of recovery room care

Equipment and staffing

Patient care in the recovery room

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PRINCIPLES OF RECOVERY ROOM CARE

The recovery room should be close to the operating theatre.Every patient who has had a general or a regional anaesthetic must be observed in the recovery room before being discharged to the ward.The patient should be on a trolley which can easily be tilted head down.

Fig 53.1 Post-operative patient in recovery position

EQUIPMENT AND STAFFING

The recovery room should have: Good lighting Adequate oxygen and suction equipment Adequate ventilation equipment:

Self inflating bag and mask Face masks and airways

Equipment for monitoring blood pressure A reliable clock with a clearly visible second hand Equipment for intravenous therapy Drugs for resuscitation

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The recovery room should be supervised by a trained nurse, who must be able to communicate efficiently and easily with the anaesthetist. It is the anaesthetist who should personally hand over the patient to the recovery room nurse and discuss with the nurse any problems that have arisen in the operating room, for instance blood loss or a fall in blood pressure.

The anaesthetist must not leave the patient until respiration, colour, pulse and blood pressure are all satisfactory.

If any anaesthetic complications such as vomiting, bronchospasm, laryngeal spasm or convulsions have developed, the anaesthetist must not leave until the problem has been treated.

PATIENT CARE IN THE RECOVERY ROOM

Careful records must be kept. All vital signs should be recorded every 10 minutes until discharge. Patients who have had spinal anaesthesia should remain in recovery for

1 hour since insertion of the spinal and ideally show signs of diminishing level of block before discharge.

If IV or IM opiate analgesia has been given patients should remain in recovery for a further 20 minutes post injection.

Conditions for discharge from the recovery room

The patient must be awake and responding fully to verbal stimuli. Breathing must be regular and deep. The colour of the mucous membrane of the lips should be pink.

Oxygen saturation if available should be normal (>95%) breathing air. The pulse should be regular and of acceptable rate. The blood pressure must be stable. If the patient is catheterised the hourly urine output should be

acceptable. Patient should have received adequate analgesia.

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