If patient wishes to try TOLAC prior to having/needing C-section, they CANNOT be considered an ERAS patient. Please do not schedule them as ERAS or tag them as "Yes, ERAS pt" in Dimensions.

PRE-OP

• Identify patient as ERAS

• Patient Guide to ERAS Booklet

  • • Confirm they brought booklet

    • Remind importance of documenting in booklet

• Patient Education Class

  • • Ask if patient completed required education class

    • If no, please review ERAS info with patient (they can still continue as ERAS patient even if they did not complete Patient Education Class)

• Clearfast ***DOCUMENT IN DIMENSIONS***

  • • CONFIRM patient drank 3 hrs before scheduled surgery time

    • Patient can still move forward as ERAS patient if Clearfast not consumed

    • If patient present from OB office or earlier than scheduled c-section date, most likely the patient has not consumed Clearfast- ***Talk with Anesthesia to see if there is enough time for patient to drink Clearfast prior to C-section***

      • • If no Clearfast on unit, this can be obtained on first floor in Wellness Clinic area

• NO SCOPOLAMINE PATCH

• Normothermic

  • • Place Warm blankets on patient

    • ALL fluids = WARM fluids

• The follow medications are ordered by surgeon

  • • Acetaminophen 1 g PO

    • Bicitra 30 mL PO

    • Pepcid 20 mg IV

***If any of the above medications are not ordered, or not ordered correctly, contact surgeon ASAP for correction (contact anesthesia if surgeon not available)***

• IV insertion

  • • Hep-locked

• LR 750 mL rapid Infusion/bolus

  • • Infuse when notified of OR availability

    • MUST BE WARMED FLUIDS

• Hand Off

  • • Confirm with CRNA ALL medications given in pre-op for safety precautions and to ensure no double dosing occurs

MEDICATION EXCLUSIONS:

• ACETAMINOPHEN (TYLENOL) DO NOT GIVE:

  • • Patients with liver disease or impaired liver function

    • Patient has taken acetaminophen in the last 8 hours

    • DO NOT exceed a total of 3 g acetaminophen in 24 hours