PONV. Post-Op Nausea and Vomiting, Pathophys., Risk Factors & 2020 Consensus Guidelines PONV, Part 1

This is the first of a three part video series covering Post-Op Nausea and Vomiting, PONV. This video covers the pathophysiology of PONV, risk factors of PONV and an overview of the 2020, 4th consensus guidelines for post-operative nausea and vomiting, PONV management. We begin by discussing the emetic center of the brain, the Medulla. Then we go deeper to understand all the chemical and sensory input that triggers post-op nausea and vomiting , like the chemoreceptor trigger zone, CTZ zone, vestibular apparatus, and more. Learn about the common risk factors associated with PONV and how to stratify each surgical patient's risk, then prepare for a proper plan to minimize this all too common perianesthesia complication.
PACU Nursing Minutes is your premier perianesthesia nursing education resource channel. Here you will find applicable information focused on registered nursing care in the post anesthesia care unit, PACU, directed towards recovery post-surgery. PACU Nursing Minutes will review evidence-based practice, that can be applied today!
The short videos are intended to guide you towards further research and education as you become an expert in perianesthesia nursing practice. Are you thinking of getting your CPAN®, Certified Post Anesthesia Nurse, well, tune in here as we discuss many of the core topics covered on the CPAN® certification test? On the PACU Nursing Minutes channel I’ll share with you specific and essential education on providing pre- and post-operative, perianesthesia nursing care.
Are you a nurse working in the ER, ICU, or step-down and considering a new chapter in your nursing career? Well, PACU Nursing Minutes is your channel to brush up on basic concepts of perianesthesia nursing, surgery, anesthesia, and common nursing intervention in the post-operative, PACU department and more!
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Cathy Zuniga, BSN, RN, CPAN
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Educating, Equipping and Empowering Nurses!
Creator and founder of PACU Nursing Minutes
Member of ASPAN, PNANA
Nurse of 21 years, I’m passionate about sharing knowledge & supporting the next generation of nurses!

[@deborahboyd641]

Your such a good teacher, thank you for your sessions 😃

[@pacunursingminutes]

Thank You Deborah! I have always enjoyed teaching and I'm thankful to share the knowledge I have gained over the years with my fellow TRIBE!

[@traceyroberts6540]

Very comprehensive! Really enjoying your clear and well researched and explained video’s!

[@pacunursingminutes]

Thank You Tracy, I love learning and sharing my knowledge with my fellow peers and the next generation of nurses! Part 2 to release 2/1/2021!

[@pacunursingminutes]

Next week, Part 2! Subscribe so you don't miss an episode.

[@Max-lg9nw]

I love this channel. Im an ex ER nurse that just started doing periop/ mostly PACU last September and this channel has taught me so much. I thoroughly enjoy your videos. They're a god send.

[@pacunursingminutes]

Thank You for your kind words!

[@kteeb5]

same!!! keep them coming i learn so much from you!

[@muneebahmed3489]

Excellent.👍

[@pacunursingminutes]

Thank you! Stay tuned for next weeks part two!

[@alyssadiceflipper5201]

I am doing research as to why I had such severe N/V from my hip laberal repair surgery in Jan 2022. My nausea continued 2 MONTHS post-op and I went through several Dr trying to figure out what caused it. Saw a ENT, Neurologist and Allergist and no one could figure it out. Day of nothing they gave me stoped the V/N but a few days later they gave me more Zofran and it worked, sorta. Unfortunately my repair failed and I have the 2nd surgery soon. Really dreading the Post Op symptoms again. This time I might try the Patch behind the ear pre-op. Wish me luck!

[@pacunursingminutes]

Hi Ohana, I empathize with you! N/V is terrible! When the nurses call you from pre-admissions screening/education inform them of your severe Post discharge nausea. The scolpalmine patch is an option to discuss and also discuss with the anesthesiologist your severe n/v there are strategies they can do to help decrease your risks of developing n/v. A newer medication called Emend, has shown superior effects than Zofran, discuss this option too with anesthesia! Your in my prayers for a successful nausea free second surgery! Big hugs 🤗 to you! Cathy

[@alyssadiceflipper5201]

@@pacunursingminutes Thank you for your encouraging words. I will look into Emend. I think they said they tried 3 different nausea meds through IV and none of them helped. I know with the patch I had a strange reaction taking it on a cruise. My eyes dried out and everything was so blurry I could not see! I told the Anesthesiologist this so maybe he didn't use it.

[@pacunursingminutes]

@@alyssadiceflipper5201 Ok stay away from the scopolamine since you know you are sensitive. It does dry out eyes and mucus membranes. Yes have a conversation with anesthesia to come up with a plan specifically tailored to you to provide prophylaxis against nausea and then a rescue medication strategy in case it does reoccur. Best to you.

[@gibby2212]

Talk to anesthesiologist about Amisulpride as a rescue med. I hear this is really effective. Off label use of an antipsychotic

[@skidmark7845]

When I woke up from l4/l5 fusion surgery, I couldn’t feel my right leg and I was sweating profusely. That’s when the vomiting started. Not sure what caused it but I know that I didn’t get any sleep the night before, I’m guessing from anxiety.

[@pacunursingminutes]

Thanks for your comment! Wow, unable to feel you leg, that is concerning, I hope all your sensation and motor movement has now returned! The sweating is most likely associated with the vomiting, the N/V highest likely cause is anesthesia. If you ever have surgery again let the nurses and anesthesia know about you history of post-op nausea so they can give you medications to help prevent this complication from repeating. Take care and Stay safe! Nurse- Cathy

[@catherinebirch2399]

They Don't explain why certain patients or surgeries increase the risk.

[@pacunursingminutes]

Hi Catherine, many ENT and Dental surgeries trigger PONV for many reasons. Here are a few, overall blood is a BIG irritant the stomach and can trigger PONV, the Eustacian tube in the ear is associated with balance and can trigger vertigo which may cause nausea to just mention a few. Others trigger the CTZ in the brain anesthetics etc.