We are reviewing our protocols around the frequency of VS with PCA, epidural, spinal analgesia (continuous or one shot neuraxial analgesia)
Thanks
Heather
Niagara
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About Me
- OPANA Ontario Perianesthesia Nurses Association
- Toronto, Ontario, Canada
- OPANA is a nursing association dedicated to the improvement of perianesthesia nursing standards.
2 comments:
Hi Heather,
if you look at the opana blog of march 08, you will see a few replies to this question.
At Trillium Health centre, the routine for PCA and neuraxial analgesia is VS q10 min x 1hr (in PACU; if pt stay is beyond 1 hr, VS may be done q 30 min if stale. Upon transfer to the inpatient areas, VS are done q2h x24 h, then q4h x 48hrs.
Along with VS, the bromage score and a sensory assessment is completed.
Heather
Trillium Health Centre
Mississauge
Hi Heather,
Unfortunately there is not much in the literature in terms of guidelines for monitoring for neuraxial blocks.
At Sunnybrook, vitals (including sedation score and pain score) are monitored q1h x 4 hours then q4h while the epidural is in. Sensory and motor testing is q 30 minutes x 2 then q1h x 3 and q 2h x 3 then q4h until removal.
In PACU at TWH, vitals were taken q15 min x 1 hour (regardless of the surgery) for the 1st hour and then q 30 min after that. I believe the monitoring on the floor is very similar to the monitoring used at Sunnybrook.I was able to find this guideline from Wisconsin that recommends vital signs monitoring and motor and sensory testing q 4 h
http://www.wisc.edu/trc/projects/pop/Epi-manual.pdf.
Another article that might be worth looking at is "Caring for the Patient with an Epidural in the Recovery Unit" (British Journal of Anaesthetic and Recovery Nursing 2006; 7, 41-43Unfortunately I did not have access to this journal, but perhaps your hospital library will be able to get it for you.
Sandra
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