AB230. Measuring and managing post operative nausea and vomiting in the post anaesthetic care unit

Background: This audit aimed to evaluate the current incidence and management of post-operative nausea and vomiting (PONV) in the post anaesthesia care unit (PACU) at University Hospital Limerick. Incidence and management of PONV were compared with guidelines set out by the Society for Ambulatory Anaesthesiology.

Methods: Data was collected using a graded questionnaire completed by PACU nursing staff during the patient’s course through post anaesthesia care over a four-week course. Data was filled out based on anaesthetic records provided to PACU staff regarding pre and intraoperative care and treatment in regards to PONV and patient’s clinical course if showed signs and symptoms of PONV.

Results: Questionnaires were completed for a total of 135 patients over this time period. Out of 135 patients 7 patients were found to be nauseated or actively vomiting in the PACU. Three of the 7 patients noted for PONV were prescribed more than one type of anti-emetic both intra/post operatively. A further 3 of 7 patients were prescribed only one type of anti-emetic intra/post operatively, and 1 patient was not prescribed any intra/post-operative anti-emetics.

Conclusions: The results of the audit show good management of PONV in the PACU with less than 5% of post-operative patients experiencing PONV while other studies show that up to 30% of patients can experience PONV1. The study also showed excellent compliance with prevention of possible PONV as only 1 patient out of 135 was not given intra/post-operative anti-emetics.

Keywords: Post-operative nausea and vomiting (PONV); post anaesthesia care unit (PACU); anti-emetic prophylaxis; anti-emetic treatment; key performance indicators in post anaesthesia care unit; peri-operative management