Created: September 24, 2023
Contributor: ERAS Cardiac TKO Writing Group
Editors: Alexander Gregory MD FRCPC • Michael Grant MD
Summary
To assist clinicians in bringing existing guidelines and best practice recommendations to the bedside, ERAS Cardiac has created a series of “Turnkey Order Sets”. These order sets have been created following review of the existing evidence, and provide a guide for implementation of these ERAS elements.
Turnkey Order Set (TKO) Methodology
To assist with implementation of cardiac enhanced recovery after surgery (ERAS), we have created a sample turn key order set (TKO). The order set has been translated by subject matter experts using accumulated evidence, peer-reviewed literature, and current enhanced recovery practices.
Orders derived from Class I or IIA recommendations across all referenced guidelines and consensus manuscripts appear in the TKO in bold type.
Selected orders that were inconsistently Class I or IIA, Class IIB, or supported by evidence published in peer-reviewed journals, were also included in italicized type.
Decisions regarding order inclusion were made based on estimated benefit, risk, cost, implementation complexity, and generalizability. Each of these orders should be considered based on local institutional priorities, resources, practices, and expertise.
The Turnkey Order Set PDF in this module is intended for use by ERAS Cardiac Society Members to assist in building order sets at their own institution. They are permitted to be downloaded.
Educational Materials
Multimodal Analgesia Turnkey Order Set
ERAS Cardiac VEC Disclaimer
The Virtual Education Center (VEC) and all included content are intended to inform ERAS Cardiac Members on a wide range of topics related to enhanced recovery. The information presented has been provided by enhanced recovery experts and is for educational purposes only.
It is not intended to describe, recommend, or suggest any specific medical practice or intervention, nor should it be considered formal medical advice or consultation. The ERAS Cardiac Society cannot guarantee that the information provided is accurate or complete in every respect. Therefore, the Society is not responsible for any errors, omissions, or clinical outcomes resulting from application of the information obtained through the VEC.
All healthcare professionals should continue to exercise sound clinical judgment and base therapeutic decisions on the best available evidence and patient specific factors.
Educational materials produced by the Society for Enhanced Recovery After Cardiac Surgery (ERAS Cardiac) may be considered Open Access. Non commercial use of ERAS Cardiac educational materials, including images, audio, and video, in whole or in part, is permitted with the following conditions:
- The content is not altered
- The listed authors of the content and ERAS Cardiac are appropriately referenced, and
- A URL address or hyperlink to the original material or the main web site [https://www.erascardiac.org/] is included in the reproduction
For questions or comments about the ERAS Cardiac VEC, please contact us.
References
- Shug SA. Acute pain management: scientific evidence, fourth edition, 2015. Med J Aust. 2016 May 2;204(8):315-7.
- Grant MC. Pain management and opioid stewardship in adult cardiac surgery: Joint consensus report of the Peri-Operative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society. J Thorac Cardiovasc Surg. 2023 Jan 28:S0022-5223(23)00089-2.
- Makkad B. Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1. Anesth Analg. 2023 Apr 20.