Sirrahsim

The patient spent several more hours in the PACU before being transferred to the floor in stable condition. So yes, it ended up being just fine to wait and see in this situation. Thank you all for your input. I am working hard to fine tune my PACU skills and transition from ICU where we work as a team to PACU where contradicting anesthesia is like questioning the Pope.

This patient with their health history and the procedure performed should have been in and out of PACU in under an hour. The patient received doses of narcotics intraop that were generous but not usually considered excessive.

How long would you let them sit that low? Even a healthy person can retain CO2 if they are hypoventilating.

I am an ICU nurse who left the world of ICU and started in the PACU recently. The training was very much focused on unit specific charting and did not cover when I should report abnormal findings to anesthesia. Recently one of the anesthesiologists was laughing about a nurse (not knowing it was me) who had contacted anesthesia repeatedly related to a prolonged and continuous respiratory rate of 5 and 6. They stated "that's what PACU is for" That brings me to the question. What parameters are appropriate to contact anesthesia for? In the ICU I would absolutely report respiratory depression, especially if persistent and with no way to monitor ETCO2. In this case the patient was extremely somnolent and would only respond for a few seconds to physical stimuli. I contacted anesthesia 3 times at 30 minute intervals to request a small dose of narcan and was told to just keep watching because "giving narcan is so mean" This same provider has also ridiculed me for contacting them after a patient with a baseline heart rate of 70 suddenly started dropping down to a heart rate of 40 after being stable for an hour after reversal with neostigmine/glycopyrolate. Are these things normal findings in PACU that I just need to monitor as they suggest? Its unfathomable to me to think of NOT reporting these findings.