Spinal Fusion, Post-Op, Adolescent Idiopathic Scoliosis (AIS) — Post-Operative Day 3 — Clinical Pathway: Inpatient

Inpatient Clinical Pathway for Adolescent Idiopathic Scoliosis (AIS) Spinal Fusion Rapid Recovery — Inpatient

Post-operative Day 3

Goals Through Discharge

  • Analgesia
  • Discharge preparation
Pain Management
  • IV analgesia
    • Continue:
      • Hydromorphone rescue IV q3hr PRN for breakthrough pain
      • Nalbuphine IV q4hr PRN for itching
      • Ondansetron IV q8hr PRN for nausea/vomiting
    • Discontinue:
      • Ketorolac IV q6hr after 8th dose
  • Oral analgesia
    • Start:
      • Ibuprofen PO q6hr
    • Continue:
      • Acetaminophen PO q4hr PRN for mild pain
      • Oxycodone PO q4hr PRN for moderate pain
      • Diazepam PO q6hr PRN for muscle spasticity
Activity/PT
  • PT and OT daily
  • Log roll independently
  • Ambulate, OOB to chair TID
  • Conquer stairs
Nutrition Regular diet as tolerated
Tubes/Drains
  • Record drain output q8hrs
  • Reinforce incision site/drain dressings as needed
Respiratory Incentive spirometry q2hrs while awake
Medication
  • Continue famotidine, bowel regimen as ordered
Laboratory/Imaging Scoliosis X-rays (if not obtained in the OR) to be obtained before discharge with EOS imaging system when available
Discharge Planning
  • Finalize discharge planning
  • Provide prescriptions for family
  • First incision dressing change at time of discharge
  • Discharge home when goals are met