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POW

Post operative care is the management of patient after surgery. This includes care given during the post operative period, both in the operation room and postanesthesia care unit as well as the days following the surgery. Eastcoast Hospital has a Postoperative ward to observe patients after operation.

The goal of postoperative care in Eastcoast Hospital is to prevent complications such as infection, to promote healing of the surgical incision, and to return the patient to a state of health.

Postoperative care involves assessment, diagnosis, planning, intervention, and outcome evaluation. The extent of postoperative care required depends on the individual's pre-surgical health status, type of surgery, and whether the surgery was performed in a day-surgery setting in the hospital. Patients who have procedures done in a day-surgery center usually require only a few hours of care by health care professionals before they are discharged to go home. If postanesthesia or postoperative complications occur within these hours, the patient must be admitted to the hospital. Patients who are admitted to the hospital may require days or weeks of postoperative care by hospital staff before they are discharged.

Postanesthesia care unit (PACU)

The patient is transferred to the PACU after the surgical procedure, anesthesia reversal, and extubation. The amount of time the patient spends in the PACU depends on the length of surgery, type of surgery, status of regional anesthesia, and the patient's level of consciousness. Rather than being sent to the PACU, some patients may be transferred directly to the critical care unit. For example, patients who have had coronary artery bypass grafting are sent directly to the critical care unit.

In the PACU, the anesthesiologist or the nurse anesthetist reports on the patient's condition, type of surgery performed, type of anesthesia given, estimated blood loss, and total input of fluids and output of urine during surgery. The PACU nurse should also be made aware of any complications during surgery, including variations in hemodynamic (blood circulation) stability.

Assessment of the patient's airway patency, vital signs, and level of consciousness are the first priorities upon admission to the PACU. The following is a list of other assessment categories:

  • Surgical site
  • Patency of drainage tubes/drains
  • Body temperature
  • Patency/rate of intravenous (IV) fluids
  • Circulation/sensation in extremities after vascular or orthopedic surgery
  • Level of sensation after regional anesthesia
  • Pain status
  • Nausea/vomiting


The patient is discharged from the PACU when patient meets established criteria for discharge, as determined by a scale. One example is the Aldrete scale, which scores the patient's mobility, respiratory status, circulation, consciousness, and pulse oximetry. Depending on the type of surgery and the patient's condition, the patient may be admitted to either our general surgical floor or our Intensive care unit . Since the patient may still be sedated from anesthesia, safety is our primary goal. The patient's call light should be in the hand and side rails up. Patients in a day surgery setting are either discharged from the PACU to the unit, or are directly discharged home after observation.