Scottish Intercollegiate Guidelines Network

77

Postoperative management in adults
A practical guide to postoperative care for clinical staff

1 2 3 4 5 6 7 8 9

Introduction Clinical assessment and monitoring Cardiovascular management Respiratory management Fluid, electrolyte and renal management Management of sepsis Postoperative nutrition Information for discussion with patients and carers Development of the guideline

1 3 11 20 28 34 39 44 45 48 49 52

Abbreviations Annexes References

August 2004

COPIES OF ALL SIGN GUIDELINES ARE AVAILABLE BY CALLING 0131 247 3664 OR ONLINE AT WWW.SIGN.AC.UK

KEY TO CONSENSUS AND EVIDENCE STATEMENTS
CONSENSUS STATEMENTS CS Statements developed from structured discussion, …ver más…

The target audience for the guidelines would be nursing, allied health care and trainee medical staff. It was suggested that a SIGN guideline could cover monitoring of postoperative patients and the investigation and management of clinical deterioration in the postoperative period.

1.2

DEVELOPING A CONSENSUS GUIDELINE
The evidence of variation in practice and the repeated calls for guidance in this area clearly indicated the need for a guideline. SIGN however, has always developed evidence based guidelines, and the lack of a strong evidence base of effective practice meant that postoperative management would not be suitable for guideline development using standard SIGN methodology. Instead, it was proposed to develop a guideline using consensus techniques. 2-6 Initial systematic searches were used to identify any relevant evidence and this was critically appraised using standard SIGN methodology. The evidence base was not extensive and was often confined to specific patient groups. The evidence that was appraised was used, together with the clinical experience of the guideline development group, to inform the formal consensus methods that were used to develop recommendations. These are presented in the form of “consensus statements”. More details of the