PACU Rotation

Post Anesthesia Care Unit (PACU) Rotation

The Post Anesthesia Care Unit (PACU) at Albany Medical Center offers a broad experience in postoperative care for inpatients, outpatients and intensive care unit patients recovering from surgery. The PACU is an area where anesthesiologists have primary responsibility for managing patients in the immediate post operative phase. Anesthesiologists are the physicians responsible for the patient in this critical time of emergence and recovery and will be called upon not just for “airway” emergencies, but also for decisions on pain management, managing patients’ hemodynamics, managing neurological status issues, nausea/vomiting, reviewing central line placements, and evaluating all other possible serious postoperative complications.  Residents learn to evaluate and manage patients using their clinical skills and medical knowledge.  Other goals include understanding the roles of nursing staff in the care of postoperative patients and arranging appropriate consultations. Residents will learn the ability to communicate with those consultants in an informed manner.  In addition to the focused PACUexperience, residents gain additional experience in postoperative pain management through involvement with the Acute Pain Service.  This provides the opportunity to manage patients' ongoing postoperative pain using lumbar and thoracic epidurals, intravenous opiates, as well as other regional analgesic techniques.

Topics covered:

  • Upper Airway Obstruction
  • Hypoxemia
  • Hypoventilation
  • Hypotension
  • Hypertension
  • Cardiac dysrhythmias
  • Agitation/confusion
  • Delayed emergence
  • Oliguria
  • Bleeding
  • Post Operative Nausea and Vomiting
  • Pain
  • Hypothermia
  • Shivering
  • Understanding ACLS algorithms
  • Correctly reading a chest x-ray
  • Regional Anesthesia
  • The Aldrete Score

Residents will be available in the main operating room and pediatric PACU as well as ambulatory surgery. Supervision will be provided by the general OR attending who was part of the patient’s primary anesthesia team and formal teaching will be provided by the head of the PACU rotation.  A series of journal articles related to PACU medicine will be provided for review and will be discussed during the rotation.  Residents will also be asked to provide a brief and focused in-service presentation to the PACU nursing staff on a topic relevant to the PACU, chosen by each resident.  In addition, residents will follow a patient from the PACU through out the postoperative period and write a case report related to the management of the patient. At the end of the rotation there will be an oral examination. 

Residents will be evaluated in the 6 core competencies (medical knowledge, patient care, interpersonal and communication skills, professionalism, practice based learning and improvement, and systems based practice) using specific web-based evaluation forms completed by supervising faculty.