Trauma Patients in the PACU

[Hopecascade]

Our Level I Trauma centers sends overflow TICU patients to the PACU. Occasionally we get patients directly from TRauma Admitting who do not need OR. TICU patients will go to the OR and be "Downgraded" to Trauma stepdown or floor while they are being operated on. They have not even recovered from their surgery or GA and are still intubated/vent. We must care for them the best we can. Recently our manager will mandate TNCC or ATLS courses for us. Has anyone else had Shock/TRauma patients in their PACU? We have ICU and floor boarder patients all the time. We are staffed 24/7 so we care for them until a room is available in ICU or they are "downgraded" to a Stepdown bed. The Trauma Attendings are not on hand in the PACU and the anethesiologist wants to sign off on their cases ASAP. We are left trying to page a resident who usually does not know who the patient even is... Is anyone else in this situation? I would be glad to hear some feedback. Thanks.

[beachgirl26r]

in my experience ANY pt can be boarded in PACU! we've had pt's transferred FROM the ICU to PACU to make room for a "sicker" pt to be admitted there. sometimes they're there for days! luckily the interns and residents are great-but usually the anesthesiologist won't get involved. he OK's the transfer-but the house staff assume responsibility. hang in there-keep asking for help when you need it. consider it a good learning experience.

[txuhsrn]

When I first read your post, I thought you must work at my hospital. The exact same thing happens at mine. We have had patients stay for days waiting for a bed. I think the record for an ICU patient is 8 days in our PACU. We also have the same trouble getting a Doctor to take responsibility. They always assume that anesthesia will continue to follow them. I don't see this geting better any time soon with the shortage of nurses, but I still love what I do.

[TraumaNurseRN]

Your Trauma Services Manager should be able to help you out there. The Trauma Surgeon assigned to the patient should provide 24/7 care as mandated by the State Trauma Board. There should be no reason a resident is involved in their care. Designation of Trauma admit is covered under that.