Cesarean delivery

baseline Review the pathway, the fasting clock, pain plan, and who to call.

path_prehab_short Less than the minimum prehab window. Use a short plan: breathing, walking, and protein — not a 4-week program.

baseline Hemoglobin is below the pathway threshold. Work it up and give IV iron if time allows.

safe_pregnancy_carb Pregnancy: do not give the carbohydrate drink. Flag aspiration precautions.

note_aspiration Aspiration precautions are on. The carbohydrate and fasting lines above are the plan to print.

baseline Clear liquids until 2 hours before anesthesia. The patient sheet uses the earlier of that time and 2 hours before arrival.

note_aspiration Aspiration precautions are on. The carbohydrate and fasting lines above are the plan to print.

baseline Stop solids 6 hours before surgery. Stop fried or fatty meals 8 hours before.

baseline Do not give a long-acting sedative or benzodiazepine premedication.

baseline Scheduled acetaminophen unless the liver plan says otherwise.

baseline Give a scheduled NSAID or COX-2 unless a safety rule holds it. Do not tell every patient to stop NSAIDs for 7 days.

baseline Single-dose dexamethasone for analgesia and nausea, unless a rule modifies it.

baseline Use the procedure-specific block.

Spinal anesthesia

safe_ponv Apfel score is at the escalation threshold. Use 3–4 antiemetics and total intravenous anesthesia. Apfel 4 (Female, Non-smoker, PONV history, Postoperative opioids expected).

Apfel 4 (Female, Non-smoker, PONV history, Postoperative opioids expected). Cesarean regimen: ondansetron, and dexamethasone after delivery.

baseline Aim for euvolemia. Avoid both liberal fluid and under-resuscitation.

baseline Active warming. Keep core temperature at or above 36°C.

baseline Treat hyperglycemia. Non-diabetic patients need a check only when clinically indicated.

baseline Mechanical prophylaxis plus pharmacologic prophylaxis once hemostasis allows.

After neuraxial anesthesia, delay the first prophylactic dose. For enoxaparin that is usually at least 12 hours after the needle, once hemostasis is secure.

baseline Intrathecal morphine as part of the spinal, with respiratory monitoring afterward.

Preservative-free intrathecal morphine with the spinal. Monitor respiration afterward.

baseline Delay cord clamping when the newborn's condition allows.

path_cesarean_early Oral intake and walking soon after cesarean, once the block is receding and bleeding is stable.

path_cesarean_early Oral intake and walking soon after cesarean, once the block is receding and bleeding is stable.

baseline Remove the urinary catheter on postoperative day 1 unless the operation requires it to stay.

baseline Do not place a drain by routine.

baseline Do not leave a nasogastric tube in by routine.