Often, critically ill patients bypass the postanesthesia unit and recover in the critical care unit. The authors discuss the need for critical care nurses to monitor patients for return of consciousness, protective reflexes, and readiness for extubation.

The specialized intense nursing care required during the immediate period of emergence from surgery and anesthesia resulted in the development of postanesthesia care units (PACUs). Recovery and discharge from the PACU require that, at a minimum, patients have adequate activity level, respiration, circulation, consciousness, and oxygen saturation. In some PACUs, these parameters are assessed by determining the Modified Aldrete Score (also known as the Postanesthesia Recovery Score)1 (Table 1). Because of the need for continuity of care, patients’ illness acuity, and cost containment, some critically ill patients bypass the normal recovery period in the PACU and go directly to an...

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