Those first 60 minutes in recovery often decide how smooth the rest goes. I set 15-minute timers for TPR, pulse ox monitoring, and a quick pain score, and I’m curious what cues or tools you rely on to catch subtle trouble early?
I add a 30-second gum check — MM color and CRT — and watch the SpO2 pleth waveform; “the waveform tells the truth” when the number lags perfusion. I keep a hand on the chest to feel for shallow or paradoxical breaths and catch new shivering early — low-tech, but my hand never needs batteries. Do you keep a Doppler running to listen for tone changes even when the MAP looks fine?
Piggybacking on @lisa_m_89’s waveform point, I keep nasal capnography on for 20–30 minutes post-extubation; a rising ETCO2 or a little “shark-fin” trace flags hypoventilation or early obstruction long before SpO2 budges. If you don’t have nasal lines, a quick jaw tone and airway noise check every 5–10 minutes has been a solid backup.
I sneak in a quick IV catheter check between your 15-minute rounds: palpate above/below the site for cool puffiness and gently flex the limb while watching the drip chamber — if flow hiccups or they flinch, I assume tissuing and replace it so we don’t lose access or miss pain meds. Tiny caveat: on bandaged limbs or spicy patients, I skip the flex and just compare limb temps. Anyone else retape routinely in the “first 60 minutes”?