Post-Anesthesia Care Unit (PACU)
What is the PACU?
PACU (which stands for Post- Anesthesia Care Unit) is also called the recovery room. It is a specialized care unit near the operating room where patients who have had surgery are cared for as they wake up from anesthesia. In the pediatric recovery room, a nurse will be at your child's bedside for the entire recovery period to ensure his/ her safety and comfort.
You may be invited into pediatric post-anesthesia care unit to be with your child as they wake up from their surgical procedure. Please understand that your ability to visit your child in the PACU depends on the activity and patient load of the unit at the time.
If you are asked to enter the PACU, you will be escorted in and out of the recovery room area either by a hospital employee or volunteer.
When you enter the PACU, you may see that there are several patients in the PACU in different stages of recovery post-anesthesia. We ask you to respect the privacy and confidentiality of all our patients and families by staying at your child's bedside. We also ask that you avoid the use of cell phones and cameras.
Before you enter the PACU, staff will first be sure that:
- No child's safety or privacy will be affected
- Your child is breathing well and has regained the ability to cough
Before you enter the PACU, you must first be sure that:
- You feel comfortable in a medical setting – you do not have to go into the post-anesthesia care unit if you are not comfortable in a medical setting
- You can provide a calm, supportive presence for your child
- You are willing to follow all directions from staff. If we cannot answer your questions or explain a situation fully at the moment you inquire, we will be sure to attend to your concerns as soon as we can.
For a patient's safety, yours or someone else's, you may be asked to leave PACU and return to the family waiting area.
What you'll see in pediatric post-anesthesia care unit
- Most children receive oxygen for a period of time after anesthesia. Sometimes children look pale, puffy or swollen after surgery. This is normal.
- Children differ in their reactions to anesthesia. Some have an upset stomach and may vomit. Often children are given medications to help decrease the possibility of nausea and vomiting. Some may have dizziness and/or blurred vision for a period of time.
- If a breathing tube is used during surgery your child may have a sore throat. This is normal.
- Children wake up differently from anesthesia. Some children wake up quickly and may be awake before their families arrive at their bedside. Other children may still be sleeping from the effects of anesthesia.
- Please do not wake your child. In our experience, children often have a gentler and more comfortable wake-up process when they do so on their own.
- Some children wake up shivering even if they are not cold. Your child will receive warmed blankets by the post-anesthesia care unit staff if needed.
- Some children who have had intravenous (IV) pain medication may have an extremely itchy nose. This itch will go away.
- Some children wake up restless or irritable. Some appear awake but are not aware of what is going on around them.
- Emergence Delirium: Some cry, thrash, arch their back, reach out and seem inconsolable, even when they are in their parents' arms. This behavior is not usually related to pain, and children do not usually remember it. This restless or irritable behavior is known as "emergence delirium". About one third of young children who have brief procedures experience emergence delirium. It may occur in children of any age, even after procedures that require a longer time under anesthesia. Emergence delirium may be upsetting for parents to see, but be assured that it will go away. Sometimes it lasts about 10 minutes; other times it may last up to an hour or longer.
- By staying calm and speaking softly, you can be a comfort to your child.
- Pain medicine is given as needed. After receiving pain medicine, children need to be observed due to the sleepiness and possible changes in breathing caused by most pain medications.
- If your child takes a comfort item along to surgery – such as a toy or special blanket – it will be with him or her in the PACU. If he is comforted by a pacifier, and it is sent with him to surgery, he will be given the pacifier in PACU (unless contraindicated by the type of surgery he or she has had).
How long will my child be in the PACU?
Because each child and each surgery are different, the length of time spent in the post-anesthesia care unit varies from a few minutes to more than 2 hours. Do not be alarmed if your child is in PACU longer than you expected. A staff member or volunteer will keep you informed.
Children leave PACU when:
- They respond to their surroundings.
- They are medically stable.
- Our staff has treated any pain they may have to the best of our ability.
Where will my child go next?
Once your child is fully recovered, and his/her vital signs are stable, he/she will be moved from the PACU. If your child requires hospital admission, he/she will be moved to a regular patient room. If he/she will be coming home with you, he'll/she'll be moved to PACU II for a minimum of a one hour stay prior to going home.
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