Published Jul 24, 2007
Proverbs 16:3
262 Posts
I'm not sure if i'm supposed to ask an OR nurse or a PACU nurse but i'm gonna take a hit here first since i got a good response here. And this is a question my friend and i have different opinions about.
When a patient comes out of the OR, what is the first thing the nurse does?
I think it's to check the vital signs.
My friend says it's to assess for pain.
And before anyone calls me dumb, let me give my rationale: i think a patient may not really be with it when they come out of surgery enough to rate their pain which is why i thought it's more important to check the vital signs first. I'm sure you'll have to assess pain but i'm thinking you have to do check their pulse ox, BP and everything first.
Which is right? i'm hoping someone here has had the experience of taking care off a patient who just came right out of surgery.
Thanks
MamaCheese
177 Posts
I've only been in the OR for 5 weeks but what I've witnessed is that anesthesia assesses for pain before we leave the OR and continually on the way in to the PACU. The first thing the PACU nurses do is vitals when we arrive. But I've also heard them ask the patient if they're in pain. The patient is usually still pretty out of it when they first arrive so my thought would be that vitals would be a better assessment of pain in the immediate post-op period.
I'm sure some experienced OR nurses can put a better spin on it
ewattsjt
448 Posts
i am a cst working on certifying for surgical assisting and in the process of nursing school. i do not transport the patient to pacu very often. in critical thinking of the situation, pain is secondary to the vitals. unless it is extreme pain (unbearable) which could implicate something major wrong. airway is always the first priority so a pulse ox for oxygen concentration is a must, bp, heart rhythms etc... should follow.
anesthesia may be asking, but they just had the vitals just a second ago and everything checked out ok before they left the room (or the patient would have not been transported).
common sense would say, "why find out the pain of a patient when they could be in an arrest?" the patient has just has anesthetics which may impair their thought. your equipment tells the real story. if you wait to see a cyanotic effect (bluing of the lips etc...) the oxygen blood sats should be in the 60s). there is only a 10 to 15 sec delay with the pulse ox.
so my opinion for what it is worth, would be get the vitals first, then get the pain assessment next.
azor
244 Posts
You take the vitals first before any other thing.it'll tell u the exact thing going on with the pt as they may still be under influence of anaesthesia.
Azor
GadgetRN71, ASN, RN
1,840 Posts
I'm not sure if i'm supposed to ask an OR nurse or a PACU nurse but i'm gonna take a hit here first since i got a good response here. And this is a question my friend and i have different opinions about.When a patient comes out of the OR, what is the first thing the nurse does?I think it's to check the vital signs.My friend says it's to assess for pain.And before anyone calls me dumb, let me give my rationale: i think a patient may not really be with it when they come out of surgery enough to rate their pain which is why i thought it's more important to check the vital signs first. I'm sure you'll have to assess pain but i'm thinking you have to do check their pulse ox, BP and everything first.Which is right? i'm hoping someone here has had the experience of taking care off a patient who just came right out of surgery.Thanks
elcue
164 Posts
oxygen!!!!!!
pulse ox 1st, then 02 if needed, then the rest of the vitals, then the rest of the assessment
linda.
bifurcated
35 Posts
If your patient is not oxygenating well then they are not in a lot of pain or cannot tell you. You always check vitals first. A good PACU nurse will be assessing their patient while hooking up monitors etc. Use your common sense if nothing else. ABC it can be very easy.