Monitoring Svo2 or Scvo2 in recovery unit??

[slb0016]

I am hoping to get some feedback from experienced PACU nurses who have worked ICU in the past...Do any of you work in a PACU that monitors invasive hemodynamics or Scvo2?

I work in a PACU-like environment but we recover patients from Non-OR procedures like IR or MRI with anesthesia, much simpler cases. Anyways, I am pretty new to this environment, I worked the past 12 years in ICU. My manager has recently asked me to provide an educational ppt to our staff regarding hemodynamic monitoring and acid base balance. Now, mind you, we RARELY even see Alines in this recovery unit much less a PA catheter or some other less invasive CCO monitor. We don't even monitor CVP.....ever. I questioned her as to what benefit this education would be when we don't do hemodynamic monitoring other than the routine vitals. She said we should be able to monitor invasive hemodynamics when the situation calls for it especially to get an Svo2 in septic looking patients....I am baffled. I always thought you needed a PA catheter for an Svo2, even for Scvo2 you would need a special central line and most of our patients are with PIV's! The other point is that if the patient was looking that sick they would transfer to the ICU....correct? I am unsure how to proceed as she seems adamant this education be given to the nursing staff....I am tempted to just focus on acid base balance/abg interpretation and interventions (even though we very rarely do abgs in this environment), leaving out the hemodynamics all together....any thoughts or suggestions?

[brownbook]

It sounds really crazy, maybe tell, or ask, your manager if you can get some ideas from the head of anesthesiology. Maybe they can explain to you why PACU might need this in-service, or maybe they'll agree it is a crazy idea?

[HeySis, BSN, RN]

I would definitely let her know that you are uncomfortable with the assignment. (is educating your peers part of your job description?)

I wouldn't try to educate on something that you are just learning, I'd let her know that since you have not done these things in your present job you don't have the latest information and that she needs to get someone with experience... not only so they can teach but so they can answer the questions that always come up like "what do you do if your patient has x,y,z going one and you've already tried a,b and c." someone with real world experience can tell the answers while you'd be standing there with all your knowledge in the power points you just presented.

[slb0016]

Thanks for responding. Have you seen any invasive monitoring like this in PACU?

Brownbook: I am not sure I want to rock the boat by going over her head just yet... I really feel like this is information that would benefit ICU nurses or maybe PACU nurses who may recover ICU patients but we DO NOT do that in this unit.

HeySis: I used to work ICU and am familiar with the material, just dont think it's beneficial to educate nurses on something they will not be doing. There are other more pertinent educational topics, IMO. This seems like and ICU educational inservice.