What is the "BEST" post-operative position for rhinoplasty patients in pacu?

[zarkasik]

What is the "BEST" position to place the rhinoplasty patient in after leaving surgery and entering/recovering in PACU. Is it supine or sims?

[djmatte, ADN, MSN, RN, NP]

Whatever position the patient is most comfortable in. Don't think there is a *best* for this particular surgery. Maybe head of bed slightly elevated if possible.

[brownbook]

I can't understand why you are not asking the surgeon?

We raise the head of the bed and if we aren't icing the face the surgeon has a cow.

I can't imagine why Sims would be suggested and how you could ice the face?

Irregardless of my brilliant response, ASK THE SURGEON!

[PACU RN CPAN]

HOB as ordered. Ice is best done by filling a glove fingers and applying to the nose area.

[HeySis, BSN, RN]

We raise the head of the bed as high as the patient will tolerate and place ice lightly on the bridge of the nose. I will often use an eye mask ice bag, not overly stuffed, because they have a strap that goes around the head and velcro that will help keep it from sliding down when patients are sitting up.

There is a a lot less coughing up of blood if the patient is upright... instead it drips down the nose, hence I place a folded 2x2 under the nose and tape it there to catch the drips.

I also will keep on the O2 face tent unit the patient is awake enough to cover their mouth when they cough (I do this with tonsils too) so I don't get sprayed with droplets of blood. (They hit the inside of the tent mask which I will use gloved hands to wipe clean until we are ready to throw the mask away).

[Mavrick, BSN, RN]

We don't do rhinoplasty but do a lot of septoplasty surgery (but still call it a "nose job")

HOB at least 60 degrees. An OR mask cut in a narrow strip with elastic band to hold a 4x4 in place under the nose as a drip pad. Eye mask ice bag not too full as previously stated and Velcro in place.

Discourage patient from swallowing blood. Better to lean face forward and let it drip out the nose onto the drip pad.

I would never ask a patient to assume Sims position in the immediate post op period I don't trust they would be able to keep a patent airway.

Worst comes to worst .... ask your surgeon.