Is PACU considered critical care?

[lsvalliant]

Hi All,

Isn't PACU considered critical care? If so, I wonder why allnurses doesn't have it categorized as so. How often does the stuff hit the fan in your PACU? What is the scariest moment you've experienced?

[nannymcpheeRN]

PACU is not exclusively critical care...it is indeed post-anesthesia which requires a unique set of skills to provide optimum care. (I've work both ICU/PACU). High critical situations are not the norm in PACU...especially with advances in anesthesia induction protocols and improvement of meds with fewer side effects. The PACU has to be prepared to act quickly and effeciently in the event of a crisis, which can come out of nowhere!!! I have beeen caught off guard a few times with life threatening cardiac arrhythmias rearing their ulgy heads in patients who didn't fit the profile for cardiac problems; the episodes where usually related to underlying conduction problems, dehydration, electrolyte imbalances. The scariest events for me in PACU is a lost airway in a child. We have 20 OR's going most days with all surgeries (except transplant surgeries) and patient ages. It's wild and varied and definitely keeps you on your toes. :redbeathe

[lsvalliant]

thanks nannymcpheeRN

I was curious because I'm starting the PACU training program at my hospital next month and I know I am attending the same critical care courses as the ICU training program. I was fortunate enough to shadow in the PACU for about a week before deciding to go into the specialty. It seemed pretty calm to me, but I'm sure unexpected and life-threatening situations arrise. Thanks for sharing your experiences.

[PostOpPrincess, BSN, RN]

Believe it or, it hits the FAN EVERYDAY.

I am ALWAYS dealing with airway, mass confusion and sometimes the neostigmine doesn't quite reverse and then we deal with so many cardiac issues.

Don't forget all of these people with co-morbidities.

It's super fast paced, and unlike the ICU--a new RN CANNOT work in our unit. He/She has to be very, very capable from the very start.

Scariest moment?

Malignant hyperthermia on a young adult. That day sucked.

[Cschroy1]

I did find this statement by ASPAN that I thought may be helpful as well on answering your question:

"Phase I PACUs are by their nature critical care units, and as such staff should meet the competencies required for the care of the critically ill patient. These competencies should include, but are not limited to, ventilator management, hemodynamic monitoring and medication administration, as appropriate to their

patient population."

I found it here: https://www.aspan.org/Portals/6/docs/ClinicalPractice/PositionStatement/8-Joint_ICU_Overflow.pdf

Hope that helps! :)

[lsvalliant]

thanks for the link!