Gastrectomy (Total/Subtotal)

ST = Subtotal

ActionsDay 0Day 1Day 2Day 3Day 4Day 5Day 6
MonitoringHourly obs (min)
Cardiac monitoring
Humidified oxygen via mask
2-4 hourly obs (min)
STOP cardiac monitoring
Humidified oxygen via mask
4 hourly obs (min)
Humidified oxygen via mask
4 hourly obs (min)
Humidified oxygen via mask
4 hourly obs (min)
Humidified oxygen via mask
4 hourly obs (min)
STOP oxygen
6 hourly obs
DVT ProphylaxisTED stockings
Clexane 6hrs post-op
TEDs - removed, legs checked,
replaced daily
Clexane
TEDs
Clexane
TEDs
Clexane
TEDs
Clexane
TEDs
Clexane
TEDs
Clexane
Pain ControlEpidural, PCA or paravertebral
IV paracetamol
PR diclofenac if required
As per day 0REMOVE Epidural or paravertebral
ORAL analgesia
ExerciseSupported to lie upright in bed
Sit out in chair (depend on time get to ward)
Leg movements in bed
Breathing exercises using incentive spirometer
Sit out in chair
Support patient to mobilise QDS
Other exercises as per Day 0
NG TubeIn placeST: Spigot (4-6hrly aspirates)Spigot (4-6hrly aspirates)
ST: Consider removal
Consider removal
Abdominal (Doudenal stump) DrainIn placeConsider removal
Urinary CatheterIn placeConsider removal
Central lineIn placeConsider removal
IV FluidsIn placeConsider stopping
Eating and DrinkingIV fluids
Liquid food via feeding tube
ST: NO jejunostomy tube
Sips of water up to 100ml/hr
ST: Free fluidsFree fluids
Cont. liquid food via feeding tube
ST: Start soft foods
as per dietician advice
Start soft foods as per dietician advice
Cont. liquid food via NGT
Wound CareNoneChange drain dressings
Surgical wounds checked
Change dressings if necessary
Leave surgical wound undressed,
if dry and healing well
InvestigationsCXR in recoveryCXR (NOT ST)
FBC, U&E
FBC, U&ECXR (NOT ST)
FBC, U&Es, CRP
FBC, U&EFBC, U&Es, CRPFBC, U&Es