pca/ortho

I would make the fluids the primary line and have to PCA hooked up to the secondary port.. Always make sure the meds in your PCA are compatible with your fluids though, or you'll need another line. I don't know much about ortho.. sorry..

we use a primary line for pca and primary fluids are secondary on the pca line but are run on there own pump, the primary line for pca discourages disconnect for possible narcotics syphoning. Our pca's must be run with a primary fluid.

We have our fluids as primary and the PCA running secondary. A PCA should not be run without having fluids infusing and our PCA orders state this as well as well as not discontinuing fluids without physician consent.

As for working on ortho, the main thing is to make sure that your patient's extremity is always elevated, do your neuro checks and ensure that they are properly medicated. At the hospital where I work at, we do alot of knee scopes, shoulder scopes and total knees. Especially with the knee and shoulder scopes, they come back from the OR with a block and at some point in time the block will start to wear off. I tell my patients that at the first sensation of pain to let me know, then we can start to medicate so that we stay on top of their pain. It's so hard to play catchup once they are hurting so bad.

Our total knee patients usually come back from the OR with an epidural, so that they are having a constant infusion of medication. As for the PCAs, sometimes they will have a PCA + continuous, PCA only, or demand only. Just depends on the doctor's orders.

Hope that this helps.