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Published in Marilyn Sue Bogner, Human Error in Medicine, 2018
Toward the end of the operation the anesthesiologist prepares to “wake up” the patient (although some patients are taken to the intensive care unit still deeply anesthetized and allowed to wake up slowly). Waking up the patient consists of reducing the level of anesthesia to the minimum necessary, reversing muscle-paralysis drugs, and allowing the patient to breathe, spontaneously. When the surgery is completed, the anesthesiologist administers 100% oxygen and when the patient is breathing satisfactorily and shows signs of regaining cough reflexes, the endotracheal tube is removed. The patient is given oxygen by mask and the ventilation carefully watched. The patient is then taken to the postanesthesia care unit (PACU, or recovery room), where specially trained nurses oversee the patient’s further emergence from anesthesia. Postoperative problems with cardiovascular, pulmonary, and other systems are managed by the PACU nurses under the immediate supervision of anesthesiologists.
General introduction
Published in Adedeji B. Badiru, Handbook of Industrial and Systems Engineering, 2013
Services in an OR are provided by surgeons, nurses, and anesthesia professionals who have been trained for different specialties. Figure 55.1 depicts the layout of MDACC's main operating suite, which consists of 32 ORs. Most are multifunctional and can accommodate different types of cases depending on the equipment and instruments that are required. For example, rooms 31 and 32 can be used for both robotic and brain surgery and have some permanently installed equipment. Most equipment, however, is stored in a nearby block of rooms, which also include break rooms for the nurses where they can rest between assignments and do their paperwork. All ORs are monitored from the control room where nurse managers continually check the status of each and coordinate the resource needs of the upcoming cases. After surgery, patients are transferred to the post-anesthesia care unit (PACU) for recovery and perhaps additional treatment.
Operating room scheduling problem under uncertainty: Application of continuous phase-type distributions
Published in IISE Transactions, 2020
Mohsen Varmazyar, Raha Akhavan-Tabatabaei, Nasser Salmasi, Mohammad Modarres
OR sequencing and scheduling determines the start time of each surgery to be performed in different surgical groups, as well as the resources assigned to each surgery over a scheduled period. The overall surgery process contains three stages in a predetermined sequence, i.e., the pre-operative stage, the peri-operative stage, and the post-operative stage (Pham and Klinkert, 2008). In the pre-operative stage, patients are transported from nursing units to the pre-operative holding unit (PHU) and then moved to an OR. In the peri-operative stage, the patient is anaesthetized for surgery by an anesthetist and then operated on by one or several surgeon(s). In the post-operative stage, the patient may be transported to one of several different destinations. Most patients are taken to the Post-Anaesthesia Care Unit (PACU) where they recover from residual effects of the anesthesia under the care of PACU nurses. The problem of OR scheduling including the PACU is commonly referred to as the Operating Theater Room (OTR) problem (Guerriero and Guido, 2011; Wang et al., 2015).
Minimising the number of cancellations at the time of a severe lack of postanesthesia care unit beds or nurses
Published in International Journal of Production Research, 2021
Danial Khorasanian, Franklin Dexter, Erik Demeulemeester, Ghasem Moslehi
The post-anesthesia care unit (PACU) is an immediate downstream unit for the operating rooms (ORs), in which patients are recovering after their surgeries. The PACU beds and nurses are two main resources in this unit. A deficiency in the PACU capacity may cause patients to be blocked in the ORs after their surgeries, and consequently the successor surgeries may be delayed or cancelled.