PACU
- Identify patient as ERAS
- Hand Off
Confirm with CRNA ALL medications given intra-op for safety precautions and to ensure no double dosing occurs
- TAP Block
Discuss with CRNA when TAP Block will be performed if not administered prior to PACU admit
- Newborn
follows mother to PACU and breastfeeding encouraged
- DIET
Patient's allowed/encouraged to eat and drink (crackers and juice) immediately after surgery as tolerated
DOCUMENT IN DIMENSIONS (INPUT/OUTPUT FLOWSHEET) IF PATIENT EATS OR DRINKS
- Initiate abdominal binder
Binder should be placed under patient before leaving PACU even if unable to connect due to frequent fundal checks (PREFER FOR ABDOMINAL BINDER TO BE CONNECTED ON ADMISSION TO POSTPARTUM)
When giving report to postpartum RN, reinforce binder must be on patient when ambulating (PREFER FOR BINDER TO BE CONNECTED AT ALL TIMES BUT, IF STILL COMPLETING FREQUENT FUNDAL CHECKS, MUST BE CONNECTED WITH ANY AMBULATION)
- Pain medication
Oxycodone 5 mg PO VPS 4-7
Fentanyl 50 mcg IV VPS >7
***Ensure appropriate medication given for patient's current pain score (take "Patient's Stated Pain Goal" into account too). ERAS Goal is to limit opioids***
- PONV
No standing order for Phenergan
- Transfer to Postpartum
After sufficient regression of neuraxial blockade, patient and baby transferred to postpartum unit
- Patient Guide to ERAS Booklet
Encourage use on Nursing Unit
Stress importance of documenting in Diaries on Nursing Unit