Facilities
The PACU ward itself should have large doors, adequate lighting,
efficient environmental control, and sufficient electrical and plumbing facilities.
In addition to bed spaces, there should be a central nursing station and physician
Figure 71-1
The postanesthesia care unit should be well lighted,
spacious, and equipped to deal with any possible postanesthetic emergency. A central
nursing and physician station is useful. Each bedside should be fully equipped with
air, oxygen, and suction. The phase 1 unit (A) is
busy, and open units are common. A phase 2 unit (B)
can be adjacent to a phase 1 unit and needs to have facilities for patients to make
the transition to a return home. (Photographs courtesy of Dr. Alex Macario.)
station, as well as storage and utility rooms ( Fig.
71-1
). Each bed space should have piped-in oxygen, air, and vacuum for
gastric suction. Some newly designed surgical facilities that focus on addressing
patient desires for privacy are dedicating a private room for each patient for preoperative
preparation as well as postoperative recovery.
Some epidemiologic evidence suggests that exposure to waste anesthetic
gases may be associated with reproductive toxicity. The National Institute of Occupational
Safety and Health (NIOSH) has established recommended exposure limits of 25 parts
per million (ppm) as a time-weighted average for nitrous oxide and a ceiling of 2
ppm for volatile anesthetics.[24]
Exposure of health
care personnel may exceed recommended levels in poorly ventilated PACU. Modern PACUs
have a high ventilation capacity, so anesthetic gases do not accumulate enough to
pose a risk.
