the individual and the surgical site.
successive plane is achieved by increasing the
concentration of the anesthetic agent in the tissue
Stage 4 is called the toxic or danger stage.
Obviously, this is never a desired stage of
At this point, cardiopulmonary
failure and death can occur.
anesthesia has been obtained, the healthcare
provider must exercise care to control the level
of anesthesia. The fourth level of consciousness
of stage 3 is demonstrated by cardiovascular
impairment that results from diaphragmatic
If this plane is not corrected
immediately, stage 4 quickly ensues (fig. 21).
For purposes of this discussion, the recovery phase
consists of the period that begins at the completion of
the operation and extends until the patient has
recovered from anesthesia.
The recovery phase
generally takes place in a specialized area called the
recovery room. This unit is usually located near the
operating room and has access to the following:
Surgeons and anesthesiologists or anesthetists
Nurses and Hospital Corps personnel who are
specially prepared to care for immediate
Special equipment, supplies, medication, and
From the time of admission to patient discharge,
routine care in the recovery room consists of the
Measuring temperature and vital signs (taken
immediately upon admission and as ordered by
the physician thereafter)
Maintaining airway patency
Patients having an artificial airway in place
will automatically expel it as they regain
Have a mechanical suction apparatus
available to remove excess excretions from
the patients airway.
Ensuring the integrity of dressings, tubes,
catheters and casts
Locate the presence of any of the above.
Make notations regarding all drainage,
including color, type, and amount.
Immediately report the presence of copious
amounts of drainage to a nurse or physician.
Monitoring intravenous therapy (including
blood and blood components)
Make notations including type of infusion,
rate of flow, and condition of the infusion site.
Observe patients receiving blood or blood
components closely for untoward reactions.
Monitoring skin color changes
Check dressings and casts frequently to
ensure they are not interfering with normal
blood circulation to the area.
Notify a physician or nurse of general skin
color changes that may indicate airway
obstruction, hemorrhage, or shock.
Assessing level of responsiveness
For general anesthetics, check for orientation
to the environment each time vital signs are
For regular anesthetics, check for return of
sensory perception and voluntary movement
each time vital signs are taken.
Observing for side effects of the anesthetic agent
Each agent has the potential for causing
specific side effects. Some common major
side effects that may occur following the
administration of both spinal and general
anesthesia consist of the following: