No patient (in-patient or out-patient) should stay in the recovery room for more than 24 hours.

A
patient who has completely recovered from the effects of anesthesia but who still needs close surveillance
should be transferred to the SICU. The demand of the operating surgeon to let his/her patient stay above
and beyond the necessary hours is probihited.

RESPONSIBLE FOR THE TOTAL CARE OF THE PATIENT

The patient care is a joint responsibility of the following:

1. Operating surgeon and his assistant.

2. Anesthesiologist and his assistant.
3. Interns on duty in the Recovery Room.
4. Nurse on duty in the Recovery Room.

RECORDING OF DATA

Vital signs should be monitored and recorded as ordered accurately and clearly in the appropriate
official monitoring form. Any significant development or incident must be recorded with the time duly
noted.

ROUTINE PROCEDURES FOR ALL RECOVERY ROOM PATIENTS (even if not specifically
ordered in the chart)

1. Proper Identification-
The patient’s name, age, sex, blood type, ward, bed number, operative diagnosis, name of
operating surgeons, known allergies should be written clearly in large easily read block letters in
the appropriate form.
Proper Identifications shall be done by the following in descending order of priority and
responsibility:
a. Operating Surgeon
b. Surgical Intern-in- Charge
c. Clinical Clerks-in- Charge or Clinical Clerk on duty

All admitted patients shall be endorsed to RR Nurse on duty.

2. Monitoring and Recording of Vital Signs

(BP, PR, RR, Temperature) and level of consciousness every 15 minutes. Fluid intake
and output ( including urine output shall be done hourly). The recording of the above parameters
shall be done by the following in descending order of priority and responsibility.
a. Surgical Clerk-in-charge or surgical clerk on duty.
b. Intern-in-charge or Intern on duty
c. Recovery Room Nurse on duty
d. Anesthesiologist in-charge or Anesthesiologist on duty

3. Checking of all tube system every 15 minutes for patency. The checking of tube systems shall be
done by the following in descending order of priority and responsibility:
a. Anesthesia Intern on duty
 b. Recovery Room Nurse on duty
c. Anesthesiologist in-charge or Anesthesiologist on duty

4. Suction of Oropharyngeal secretion shall be done as often as necessary. It shall be done by the
following in descending order of priority and responsibility:
a. Recover Room Nurse on duty
b. Anesthesia Intern on duty
c. Surgical clerk in-charge or Surgical clerk on duty

5. Side rails must be placed for all patients who are unconscious, semi-conscious, disoriented or
otherwise likely to fall out of bed. The placing of bed rails shall be done by the following in
descending order of priority and responsibility:
a. Recover Room Attendants and Helpers
b. Recovery Room Nurse on duty and Assistance

6. Monitoring and Recording of O2 saturation ( use of pulse oximeter) and central venous pressure
shall be done by the following in descending order of priority and responsibility.
a. Anesthesiologist in-charge or Anesthesiologist on duty
b. Anesthesia Intern on duty
c. Operating Surgeon or Surgical resident on duty
d. Recover Room Nurse on duty

ORIENTATION OF THE RECOVERY ROOM PERSONNEL

The orientation of residents, interns, clinical clerks assigned to the recovery room shall be the
responsibility of the Chief Anesthesiologist and his consultant and resident staff assisted by the Head
Nurse of the Recovery Room Unit.

All new personnel must be oriented to resuscitation techniques, routine procedures, recovery
room guidelines and policies before being allowed to participate in the care of the recovery room patients.

The orientation of the student nurses and nurses newly assigned in the recovery room shall be the
responsibility of the Head Nurse and the Recovery Room staff nurse as far as nursing function are
concerned.

INFECTED CASES

NO infected cases shall be admitted in the Recovery Rom.

Infected cases shall be transferred directly to the ward.

ATTITUDE TOWARDS VISITORS

Absolutely no visitors or other unauthorized persons shall be allowed in the RR at any time. The
staff nurses on duty shall report a list of the names of the patients in the RR in clear legible block letters
on the outside of the RR door. They shall entertain legitimate inquiries from immediate relatives and
authorized persons courteously, accurately, and truthfully.

DECUROM IN THE RECOVERY ROOM

The Recovery Room is not a place for socializing, boisterousness or picnic. Smoking in the
Recovery Room is absolutely prohibited.

LINES AND LEVELS OF AUTHORITY AND CHANNELS OF COMMUNICATION

During office hours the anesthesia resident-in-charge shall be responsible for the admission and
discharge of patients in the recovery room. He shall immediately report any problem regarding recovery
room policies and rules to the anesthesia chief resident who in turn will inform the anesthesia senior
resident. However, after office hours such functions and responsibility will be taken over by the
anesthesiologist on-duty.

IN the event of onflict between the orders of surgeon and anesthesiologist the orders of the
anesthesiologist shall prevail when question of ventilator problems are involved, and in the admission and
discharge of patients. In all other circumstances the order of the operating surgeon shall prevail (e.g.
treatment of shock, type, amount and rate of administration of I.V. fluids, etc.) If necessary a consultation
between a senior surgeon and anesthesiologist concerned with the case shall be held to resolve difference
of opinion.

The anesthesia chief resident must pass all important information and observation to the Surgical
Chief Resident.