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Scoring systems have been devised to facilitate timely and safe PACU discharge and assess home readiness after ambulatory surgery. The Aldrete scoring sys-tem, which includes activity, respiration, circulation, consciousness, and oxygen saturation, helps guide recovery from the PACU in the ambulatory surgery unit. Scoring systems and guidelines that standard-ize patient discharge from the ambulatory surgery center to home are also available (seeTables 44–4, 44–5, 44–6, and 44–7).
Criteria for discharge generally require that the patient:
· Is alert and oriented to time and place
· Has stable vital signs
· Has pain controlled by oral analgesics or peripheral nerve block
· Has nausea or emesis controlled
· Is able to walk without dizziness
· Has no unexpected bleeding from the operative site
· Is able to take oral fluids and void
· Has discharge instructions and prescriptions from the surgeon and anesthesiologist
· Accepts readiness for discharge
· Has a responsible adult escort present
Increasingly, patients are not being required to drink or void before discharge from ASCs. Such patients require plans and instructions for follow-up care to provide for possible rehydration and bladder catheterization, if required.
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