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Equipment

An automated blood pressure device, pulse oximetry, electrocardiographic monitoring, and intravenous supports should be located by each bed. An area for charting


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and storage of bedside supplies is also necessary, with sterile suction, catheters, needles, syringes, gloves, and a titratable oxygen flow meter available at every bedside. Capability for arterial and central venous pressure monitoring, as well as intracranial pressure monitoring, is also required in hospitals where critically ill postoperative patients use the PACU.

A supply of immediately available emergency equipment should also be located in the PACU and should include an airway cart consisting of oral and nasal airways; orotracheal, nasotracheal, and tracheostomy tubes; laryngoscopes; bronchoscopes; and hand ventilating devices. Self-inflating bags with positive end-expiratory pressure (PEEP) valves are also useful. A defibrillator capable of synchronized defibrillation should be available, as well as an electrocardiograph, pacemaker, and pacing wires.

A "crash cart" containing cardiopulmonary resuscitation equipment and emergency drugs should be available and fully stocked at all times. Chest tube trays, cut-down trays, and tracheostomy trays are necessary.

Automated patient tracking systems that use computers to provide real-time information on the location and status of surgical patients in the operating room suite may become more prevalent. These systems provide video displays of real-time surgical case information. The information is maintained by the use of bar code scanners, magnetic readers, or common keyboard-based input terminals.

Automated patient tracking systems can provide the PACU with information regarding room utilization, delays and cancellations, in-transit times, and expected arrival at the recovery room. This information may facilitate staffing. It is not known how these operating room management information systems affect PACU efficiency. Computer-assisted charting of patient vital signs, notes, and laboratory data is becoming more common. Again, their impact on PACU efficiency is unknown.


TABLE 71-2 -- Recovery parameters after propofol versus desflurane



Following Commands (P Value) Sitting (P Value) PACU Discharge (P Value)
Reference Duration of General Anesthesia, min (SD) Numbers of Subjects (Propofol, Desflurane) Mean Recovery Time with Propofol — Recovery Time with Desflurane (min)
Juvin[27] 200 (65) 14, 14 6.9 (P < .02)
-11 (NS)
Song[28] 161 (7) 40, 40 4.9 (P < .05)
-15 (NS)
Boldt[29] 115 (27) 20, 20

1 (NS)
Lebenbom-Mansour[30] 91 (32) 14, 16 3 (NS)
-53 (P < .05)
Rosenberg[31] Not given 25, 25

-14 (P = .09)
Raeder[32] 63 (25) 31, 30 1.2 (P < .02) -2 (NS) -2 (NS)
Van Hemelrijck[33] 62 (34) 23, 23 1.9 (NS) -2 (NS) -5 (NS)
Rapp[34] 49 (37) 23, 22 -0.4 (NS) -47 (P < .01) -3 (NS)
Wrigley[35] 43 15, 15 0.6 (NS) -4 (NS)
Ashworth[36] 24 (11) 30, 30 1.5 (NS) -2 (NS) -1 (NS)
Graham[37] 20 (7) 13, 15 0.3 (NS) 1 (NS)
NS, not significant.

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