PAU & PACU

Pre-Operative Anesthesia Evaluation and Consultation Service (PAU)

The rotation on the Pre-Operative Anesthesia Evaluation and Consultation Service is a two-week rotation in both the CA-1 and CA-2 years. Patients are sent to this unit by the surgeon for a preoperative evaluation. The resident is expected to evaluate each patient and recommend, if necessary, further testing and/or consultation with a subspecialist for optimal preoperative management. The resident is also expected to evaluate inpatients on the add-on list and inpatient consultations to determine their readiness for the operating room.

Post-Anesthesia Care Unit (PACU)

The Post-Anesthesia Care Unit (PAU) provides training in the postoperative care of surgical patients. During the CA-1 or CA-2 years, residents will spend two weeks covering the PACU. As team captain, a CA-3 resident is responsible for the management of the patients in the PACU in the evenings and on weekends. The Milstein Hospital has 33 operating rooms and three cystoscopy suites. At the Milstein Hospital there are approximately 70–90 patients admitted to the PACU each day. Between 40–50 percent of them are ambulatory and will be discharged home directly from the PACU.

The PACU resident, under supervision of the PACU attending, will have the responsibility for the initial postoperative evaluation and care of the patient from admission until discharge. Cases throughout the day widely range in complexity, from a straightforward MAC case that will stay in the PACU for an hour to a critically ill patient who may require mechanical ventilation and hemodynamic support. It is very common that patients who require ICU level of care remain in the PACU overnight.

The teaching experience begins in the morning, when the resident and attending covering the PACU get sign out from the previous night’s team captain on patients remaining in the PACU overnight. Throughout the day, as new patients arrive, the resident keeps in close contact with the attending as they review and manage patients together. Other responsibilities may include the evaluation of patients for emergency surgery and anesthesia consultations.

The medical director of the PACU is Dr. Tricia Brentjens. The majority of the faculty who attend in the PACU on daily basis are trained in critical care medicine.