Care of a post-op patient with laryngospasm in recovery
The written assignment must be presented using Driscoll reflective framework that incorporates an introduction and conclusion. The assignment should be a description and analysis of the care provided by the Registered Nurse to a patient, in the post anesthetic care unit (PACU).
This must include care relating to:
– Airway management
– Homeostasis and hemodynamic monitoring
– Assessing pain and pain management
– Management of post-operative nausea and vomiting
– Discharge planning and criteria
For the assessment of the patient the ABCDE assessment should be used.
The outcomes and conclusion of the assignment should focus on an action plan for future practice, synthesizing the care concepts, knowledge acquisition, beliefs and perspectives formed.
Model of reflection to be used in the essay is Driscoll, please see pdf attachment doc. (please do not mention anything else about the framework chosen, we don’t need to justify why this model was chosen)
For the ABCDE approach please see https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/
AAGBI Guidelines please see: https://www.aagbi.org/sites/default/files/immediate_post-anaesthesia_recovery_2013.pdf
Case to be studied:
The patient is a 45yrs. old Muslim female who underwent a laparoscopic myomectomy. No past medical history, otherwise fit and healthy. Surgery went well without intraoperative issues. Anasthesia/intubation went fine, no issues there either.
On arrival to Recovery: Extubated in Recovery by the anaesthetic consultant. Breathing, RR 8-10 breaths a minute, Sats 98%, otherwise all vital signs between normal ranges. 2 -3 minutes after handover patient went into laryngospasm but managed without the need of the patient to be reintubated. Apart from the laryngospasm in Recovery, when patient more awake she required 16 mg iv Morhine and antiemetics to help with the nausea.
-patient had one cannula in situ and had Hartmanns running
-No drains, 3 clean laparoscopic wounds
Our focus in the essay should be airway and breathing management of this particular patient that required treatment for laryngospasm, as well as pain and nausea management.
-for pain management intra-op she had Fentanyl and Paracetamol, for nausea Ondasetron 4 mg
-in Recovery, the patient was prescribed IV Morphine for recovery, more Ondasetron or Cyclizine as antiemetics. For the ward she had prescribed Oramorph (prn), regular Paracetamol and Codrydamol