Percentage of patients 3 through 17 years of age, who receive appropriate antiemetic prophylaxis preoperatively and/or intraoperatively.
Postoperative nausea and vomiting (PONV) is a common and unpleasant outcome of anesthesia care that can lead to other complications, lengthening the patient’s recovery period after surgery2. Effective management of PONV leads to optimal patient outcomes and comfort during the postoperative period.3 Combination therapy that includes two prophylactic pharmacologic anti-emetic agents of different classes is most effective when managing PONV in children.4,5
A separate PONV risk model should be considered for pediatric patients as many proven risk factors for adults are difficult to assess or do not apply to children.6 The independent PONV risk factors identified for pediatrics include post-pubertal females, positive history of PONV (individual and/or immediate family), at risk surgery (strabismus, adenotonsillectomy, otoplasty), administration of long acting opioids and volatile anesthetic duration greater than 30 minutes.1 Although including a prophylactic anti-emetic administration protocol that considers such risk factors has shown to reduce the incidence of PONV, there is high variability in this outcome.7,8
4 hours before Anesthesia Start to PACU Start
Patients ≥ 3 and < 17 years old who have one or more risk factors for PONV:
All patients are assumed to have 1 risk factor based on age inclusion criteria (3-17yo).
Long Acting Opioids
Concept_ID Opioids
10219 HYDROMORPHONE
10279 MEPERIDINE
10290 METHADONE
10306 MORPHINE
10341 OXYCODONE
10481 OXYCODONE / ACETAMINOPHEN 5 MG / 325 MG
10482 HYDROCODONE / ACETAMINOPHEN 5 MG / 325 MG
10483 HYDROCODONE / ACETAMINOPHEN 7.5 MG / 500 MG
Provider(s) signed in at Induction End.
Method for determining Responsible Provider:
Antiemetic (by class)
Class: 5-Hydroxytryptamine (5-HT3) Receptor Antagonists
Anticholinergics
Antihistamines
Butyrophenones
Neurokinin-1 Receptor Agonists
Phenothiazines
Steroids
Prokinetic
Other
Measure Author |
Institution |
Meridith Wade, MSN, RN |
University of Michigan |
Rob Coleman |
University of Michigan |
MPOG Pediatric Subcommittee |
Date Reviewed | Reviewer | Institution | Summary | QC Vote |
---|---|---|---|---|
NA |
NA | NA | NA | NA |
Date | Criteria | Revision |
---|---|---|
01/18/2022 | Exclusion | Added MAC/Sedation exclusion |
11/11/2021 | Exclusion | Added Radiation Oncology room tag exclusion |
09/15/2021 | Exclusion | ECT: Modified to use new phenotype |