Average recovery times? - page 2
by luckynurse_1234 | 4,468 Views | 10 Comments
Our surgical recovery is split into two areas for ambulatory procedures: acute anesthesia recovery in a gurney, then we move patients into chairs before they go home. I am curious how long patients in other hospitals spend in... Read More
- 1Sep 16, '12 by Perpetual StudentI work both phase I and phase II in a mixed inpatient and outpatient department. We typically use the gurney from the time the patient changes into the clothes until the time he goes home/to the floor. So furniture isn't really a factor in our practice.
Typical phase I time is about 45 minutes for most outpatient general anesthesia cases. We hold onto everyone for at least 30 minutes, in part due to the amount of time it takes to get the post-op orders from the surgeon and get our paperwork done. Ideally, the patient will be awake, have his pain under control, and not be particularly nauseated by the time he's transferred to phase II or the floor. I've kept inpatients for a few hours even when a bed is available in order to get their pain under control and then make sure they keep breathing. I'll take however long I need to, though I do try to move people as soon as they're ready for the next step.
Phase II time is typically about 40 minutes, though both can vary considerably based upon patient needs. I've occasionally received a patient out of the OR, recovered 'em, and discharged 'em to home in about an hour. One little boy who was very eager to go to a BBQ comes to mind. If only the men were always as manly as that boy!
Treat opiod tolerant patients aggressively, taking into account their usual routine, their level of sedation, and degree of pain. It is unrealistic to expect to not hurt, but pain should be minimized. If they're inpatients, don't hesitate to throw in some benzodiazepines, esp. in drug abusers. If they're outpatients, consider small doses of midazolam (sometimes even .5mg of midaz can do wonders).
I don't mess around with nausea, either. Complain to me and you're going to be getting an antiemetic every 5-10 minutes until I run out of ordered drugs (and I'll seek further drugs to cover other receptors as needed) as well as an appropriate volume of fluid. While it is indeed true that often time does a lot to help with nausea, the drugs do work and it's only humane to use them.
Granted, if you've given ondansetron, metoclopramide, droperidol, a scopolamine patch, and fluid to a patient who still feels nauseated, he may need to go home that way. I wouldn't rush him, though. I've had some folks who do indeed want to get a move on once you've thrown the kitchen sink at 'em. They're gonna be nauseated wherever they are, might as well get home where they can be more cozy. Also, don't forget other measures such as a wet, cool cloth.