Post-Anesthesia Care and Pain Management Support
What the exam tests
Post-Anesthesia Care and Pain Management Support tests safe handover, Aldrete scoring, airway monitoring, PONV, pain assessment, and discharge readiness.
Core rules and concepts
- Handover should include surgery, anesthesia, airway, drugs, fluids, blood loss, allergies, and expected complications.
- Aldrete score assesses activity, respiration, circulation, consciousness, and oxygen saturation; each is scored 0–2, maximum 10. A score of 9 or more is commonly required for discharge.
- Monitor airway, breathing, circulation, temperature, pain, nausea, urine output, and surgical site. Opioid-induced sedation precedes respiratory depression.
- PONV: ondansetron 4 mg, dexamethasone 4–8 mg, and droperidol are common; treat pain multimodally to reduce opioid use.
- Pain is assessed with a validated scale; moderate to severe pain needs prompt treatment within scope and policy.
Worked example
A patient is awake, moves four limbs, has stable blood pressure, but saturation is 90% on room air and the Aldrete score is 8. Reasoning: do not discharge. Apply oxygen, coach breathing, assess for airway obstruction or hypoventilation, and reassess. Discharge requires sustained oxygenation and a score of 9 or more.
Traps
Do not discharge a patient with a falling saturation or increasing sedation. Do not treat pain with repeated opioid boluses without reassessing sedation. Do not ignore PONV or hypothermia. Do not accept a verbal handover without checking the airway and lines. Do not rely on a single Aldrete score without clinical assessment.