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Chapter: Clinical Anesthesiology: Anesthetic Management: Ambulatory, Non operating Room, & Office-Based Anesthesia

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Anesthesia: Discharge Criteria

Scoring systems have been devised to facilitate timely and safe PACU discharge and assess home readiness after ambulatory surgery.

DISCHARGE CRITERIA

 

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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