Table 2 Surgical ward care: an overview of facilities
Observation | Monitoring level | Treatments goalsa | Comments |
|---|---|---|---|
Level of consciousness | Every 8 h | GCS: 15 | |
Respiratory rate | Every 8 h | RR: 10 to 20 | |
Oxygenation | Every 8 h | SpO2 ≥94% | Continuous pulse oximetry is not available |
Blood pressure | Every 8 h | MAP: 65 to 110 mmHg | |
Heart rate | Every 8 h | HR: 50 to 100 | Continuous ECG is not available. Diagnostic ECG on indication. If arrhythmia or ischaemia is detected the treatment goals are adjusted to current recommendations |
No ischaemia | |||
Diuresis | Every 8 h | ≥0.5 mL/kg/h | |
Temperature | Every 8 h | 36°C to 38°C | |
Pain Visual Assessment Score | Every 8 h | VAS: 0 to 2 during rest Epidural: Able to move both legs | |
Central venous pressure | Not available | ||
Central venous oxygen saturation | Not available | ||
Standard blood samples | Every 24 h | Within normal reference values | Hgb ≥4.5 mmol/L |
Hgb ≥6.0 during sepsis or heart disease | |||
Treatment (if needed) | Maximal treatment level | Treatments goals | Comments |
Infusion of sympathomimetic drugs | Not available | ||
Oxygen therapy on open air systems | Continuously | SpO2 ≥94% | Unless contraindicated. Oxygen therapy is discontinued when oxygenation is above ≥94% without oxygen therapy. During nights: minimum 2 L supplemental oxygen is given |
Positive Expiratory Pressure (PEP) therapy | Assistance to PEP therapy: every fourth hour during day and evening shift | SpO2 ≥94% | If the patient does not need assistance with PEP therapy, guidance in self-administration of PEP therapy is available |
Non-invasive ventilation | Not available | ||
Volume / Fluid therapy | Continuously | Systolic blood pressure: ≥100 mmHg | Fluid balance: Evaluation frequency in accordance with monitoring level and vital signs |
Diuresis: ≥12 mL/kg/day |