ERAS protocol in trauma | Standard recovery protocol in trauma | |
Preoperative care | ||
Counseling | Explained in brief while taking consent | Not done |
Bowel preparation | Not possible | Not possible |
Carbohydrate loading | Not possible | Not possible |
NG tube and urinary catheter | Placed always | Placed always |
Preoperative antibiotics | Inj. Augmentin 1.2 g intravenously and inj. metronidazole 500 mg three times per day | Inj. Augmentin 1.2 g intravenously and inj. metronidazole 500 mg three times per day |
Intraoperative care | ||
Goal-based fluid therapy | Not done | Not done |
Intraoperative warming | Done with warming device always | At the discretion of the team |
Drain placement | At the discretion of surgeon | At the discretion of the team |
Epidural analgesia | Placed if there are no contraindications | At the discretion of the team |
Postoperative care | ||
Removal of tubes | Remove NG, urinary catheter and drain at 24 hours | Removed at the discretion of the surgeon |
Initiation of liquid diet | At 24 hours after operation | At the discretion of the surgeon |
Initiation of solid diet | At 24 hours after initiation of liquid diet, if tolerated the liquid | At the discretion of the surgeon |
Postoperative pain relief | Paracetamol 1 g intravenously four times per day, inj. diclofenac 50 mg intravenously three times per day, epidural if inserted, morphine as rescue analgesia. Converted to oral medications once solid diet is initiated | At the discretion of the surgeon |
Thromboprophylaxis | Mechanical sequential compression device, inj. Clexane 0.1 mg per kg once daily if there are no contraindications | At the discretion of the surgeon |
Ulcer prophylaxis | Inj. pantoprazole 40 mg intravenously once daily converted to oral once solid diet is initiated | At the discretion of the surgeon |
Postoperative antibiotics | Inj. Augmentin 1.2 g intravenously two times per day and inj. metronidazole 500 mg intravenously three times per day Antibiotics were given for 5 days and then converted to oral if discharged before 5 days | At the discretion of the surgeon |
Rehabilitation | Physiotherapy-assisted walking, chest physiotherapy and incentive spirometry started at 24 hours after operation | At the discretion of the surgeon |
Follow-up | In outpatient department (OPD) at 7 days after discharge and at 30 days (OPD or telephonic) | In OPD at 7 days after operation |
NG, nasogastric.