PACU bypass: Stage I bypass criteria

Generic Clinical Sciences

Aldrete’s original scoring system has been modified, but originally required a score of 9 or greater to leave the PACU (i.e. you could only miss one point on the following scale)

  •  Able to move four extremities on command: 2
  •  Able to move two extremities on command: 1
  •  Able to move 0 extremities on command: 0

Breathing :

  •  Able to breathe deeply and cough freely: 2
  •  Dyspnea: 1
  •  Apnea: 0

 Circulation :

  •  Systemic blood pressure ≠ 20% of the preanesthetic level: 2
  •  Systemic blood pressure is 20% to 49% of the preanesthetic level: 1
  •  Systemic blood pressure ≠ 50% of the preanesthetic level: 0

Consciousness :

  •  Fully awake: 2
  •  Arousable: 1
  •  Not responding: 0

 Oxygen Saturation (Pulse Oximetry):

  • 92% while breathing room air: 2
  • Needs supplemental oxygen to maintain saturation >90%: 1
  • 90% even with supplemental oxygen: 0

 Adapted from Aldrete JA (see Sources)

Discharge to Home

Patients who score of 9 or greater and have an appropriate escort are ready to go home

Adapted from Table 85-15 – Criteria for Determination of Discharge Score for Release Home to a Responsible AdultVital Signs (stable and consistent with age and preanesthetic baseline):

  •  Systemic blood pressure and heart rate within 20% of the preanesthetic level: 2
  •  Systemic blood pressure and heart rate 20% to 40% of the preanesthetic level: 1
  •  Systemic blood pressure and heart rate >40% of the preanesthetic level: 0

 Activity Level:

  • Steady gait without dizziness or meets the preanesthetic level: 2
  • Requires assistance: 1
  • Unable to ambulate: 0

Nausea and Vomiting:

  • None to minimal: 2
  • Moderate: 1
  • Severe: 0

Pain:

  • Minimal to no pain, controllable with oral analgesics: 2
  • (above conditions not met): 1

Surgical Bleeding (consistent with that expected for the surgical procedure): 

  • Minimal (does not require dressing change): 2 
  • Moderate (up to two dressing changes required): 1 
  • Severe (more than three dressing changes required): 0

Modified from Marshall and Chang F (see Sources)

23%

Answered correctly

2010

Year asked