Cases are better worked up by senior surgeons

The situation of postoperative care in smaller nursing home is below standard. Sometimes the operative surgeon is the only resident doctor. In others the theatre sister is the only experienced member in the nursing home. The staff in the ward can hardly be trusted. The best plan is to see that the patient recovers completely on the operation table, the anaesthetist or surgeon stays back till the patient is completely recovered. Some of the most dangerous situations in smaller nursing homes are:
-A major operation done with unstable cardiac and respiratory system
-Patient returned with an airway deeply anaesthetized
-Patient operated for septum with both nostrils packed and no airway provided.
-Long acting agent used for spinal is usually blamed for post operative hypotension which remains unattended.
-Toxic patient with persistent hypotension
-Partially recovered patient from muscle relaxation
-Patient under hypothermia
-Patient operated in oral cavity not recovered fully and no airway provided
-Infants who have been intubated
-Patient operated for upper respiratory tract obstruction.
-Patients on treatment for diabetes or hypertension
-Moribund patient with CVS and RS instability
Patient with previous MI
-Patients heavily sedated, operated under local, suffering from chronic bronchial asthma or chronic severe emphysema.