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Post Anesthesia Care Unit

Sinai Health System

Dr. James Teresi

The Post Anesthesia Care Unit (PACU) at Mount Sinai Hospital has a total of 48 specialized bays that allows for the provision of care beyond the expected post anesthesia recovery period. 

All same-day admissions for surgery are processed within the PACU which avoids unnecessary utilization of ward beds prior to surgery and allows for final assessments by the Surgeons, Nurses, and Anesthesiologists immediately prior to commencement of surgery. 

The Block Room is allocated five of the forty-eight Bays in Pod D with the ability to flex back to recovery bays as needed.  There is cross-over of PACU nurses to the block room who have undergone special education, along with PSAs and an Anesthesia Assistant, all of whom help to make the Block room a huge success.  There are presently five RNs trained and functioning in the Block Room with two more nurses undergoing training and orientation at present.   

Medical therapies which include IVIG, IV iron, and IV Magnesium with a focus on pre-operative patient optimization and blood conservation are carried out in Pod A of the PACU with approximately 40 to 50 patients per month.   These therapies are performed on an outpatient basis with the PACU handling the entire process.

The PACU provides pre and post care to many of the Wasser Pain Clinic patients who undergo nerve blocks for chronic pain within Mount Sinai’s surgical suite (please see the Wasser Report under Division of Pain Medicine).

The PACU utilizes a portion of Pod D (separate from the Block Room) for short procedures requiring anesthesia care including Electroconvulsive Therapy (ECT), Transesophageal Echocardiography (TEE), and Cardioversions.  Utilizing the PACU resources the psychologists, cardiologists, and anesthesiologists are able to provide safe and cost-effective care for this patient population which includes both inpatients and outpatients.  The integral functioning of all team members including clerical administrators, nurses, PSAs, and anesthesia assistants make this all possible.

Toronto General Hospital

Dr. Martin Ma


The TGH PACU is unique in its ability to function as a “mini” ICU.  As a result, patients who require short term hemodynamic, metabolic, or ventilation support postoperatively are commonly brought to PACU. 

The PACU team also continues to successfully fast track liver transplant and transcatheter aortic valve implantation (TAVI) patients which has significantly reduced ICU bed utilization.  

PACU also functions as a multidisciplinary management / consultation area where other disciplines, such as transplant, nephrology, medicine and cardiology are frequently involved in a team effort to effectively manage patients. 

The PACU continues to provide care for a wide range of services including electroconvulsive therapy (ECT) and elective cardioversions. The PACU has also become home for the anesthesia block corner which is routinely used to place preoperative brachial plexus blocks for arterio- venous fistula patients, and by the transitional pain service for chronic pain blocks. 

Toronto Western Hospital

Dr. Natalie Clavel


The Post Anesthesia Care Unit (PACU) at Toronto Western has a maximum capacity of 11 beds. The Day Surgery Unit (DSU) can accommodate 14-20 patients.  

The PACU (Phase I Recovery) saw upgraded monitoring equipment installed for the successful deployment of EPIC in March 2022. The equipment is identical to that used in the operating room and ICU; each unit can also be used as a patient transport monitor. The units allow for seamless capture, display, and integration of perioperative patient vitals into the patient chart via EPIC. Planning is currently underway for the construction of a new Surgical Tower and PACU/DSU facilities at Toronto Western Hospital; it is anticipated to be operational in 2027.


The Day Surgery Unit (Phase II Recovery) continues to facilitate the rapid flow of an increasing number of day surgery patients direct from the operating room, bypassing Phase I Recovery.


An increasing number of elective surgical procedures have been successfully offered as ambulatory surgery, thus minimizing the impact of hospital capacity on surgical activity. In 2021, the Surgical Procedure Unit was opened to increase capacity for outpatient minor plastic and orthopedic surgery performed under regional anesthesia. In 2021, TWH began providing elective bariatric and orthopedic surgery on Saturdays.