Hypoxemia Risk Protocol (HRP)

[HEFFLY]

Hi,

Is this a hospital protocol, or ASPAN directed? Our high risk patients, with HRP score of 6, must be kept 2 hours minimum in the PACU even if they're being admitted. Outpatients, the same time.

What's your protocol?

[Hopecascade]

Nocturnal hypoxemia in subjects at high risk for OSA is associated with an increased potency of opioid analgesia.

We follow ASPAN recommendations for OSA patients as best that we can. We do not have the protocol you mentioned. Is that from your Anesthsia dept.?

[whichone'spink, BSN, RN]

Oh wow. I've had many patients that were and are at greater risk of hypoxemia, but no set protocol. If I was having a hard time weaning a patients, especially an outpatient, then I would have that patient longer. But that's a judgement call, not a set protocol. I tend to keep patients for longer anyway, regardless of risk.

[twozer0, NP]

No protocol here at our facility. That sounds like your Anesthesia dept set that up as we follow aspan guidelines here and have never had any mention of this. To be honest, it sounds like a lean process that was put forth (which I hate btw) because they want everything to be algorythm based instead of clinical judgement. You have more of a risk of hypercapnia in the post setting which will lead to hypoxemia. Do you routinely use CO2 monitoring to help prevent this? Do you use bipaps at all to help mitigate these types of situations?