PACU discharge criteria

Friesw/that · Jan 22, 2004

in our pacu we have pre-printed discharge orders

overall, patients have to meet the following:

awake, alert, oriented(provided they were prior to surgery)

if not, must be at pre-op mentation

no active nausea and/or vomiting

stable vital signs with bp with-in 20% of pre-op value

free of pain, or at comfort level to maew, cough and/or deep breathe

a numeric scoring system can also be used, such as aldrete

clinical assessment must also be taken into consideration, for example are the dressings copiously bloody, do they have adequate uop, are they normothermic(in our pacu, a pt's temp must be at least 97.0 orally)

if the patient is to be dc'd to home, they must void, be relatively pain free, and meet the above criteria--which includes verbal and written dc instructions, and a driver.

if there is ever any doubt, we always consult our anesthesia provider.

hope this helps

sharann, BSN, RN · Jan 22, 2004

Usually the anesthesiologists must write a number between 0 and 10 for the Aldrete score the patients may be DC'd at.

The Aldrete score doesn't have to be 10, it just hast to be at or above what the anesthetist states it must be. If the pt doesn't meet the criteria, we call the anesthetist and ask for a revision of scores or if appropriate, for treatment.

So our criteria is the matching Aldrete scores.

dkrn · Jan 22, 2004

So pretty much the same as us. Good! But what do you if the patients temp is not 97 orally? Sometimes we have big bowel cases and their temps after an hour in PACU are only let's say 95.6,That's using a bear hugger and all. Do you send them to the floor or keep them in PACU? We are a small rural hospital so we don't have a PACU step down or anything like that. Only M/S or ICU. Thanks

Friesw/that · Jan 24, 2004

that's why protocols/policies are important

anyhoo, since you don't have those yet, God gives us prudence

do you feel ok sending a patient to the floor with a temp of 95.0

how busy are your med-surg floors

will this patient be immediately seen to, or left to continue to drop temp, along with mentation

sometimes when our floors are busy, i will keep a patient a little longer(if i can), and make sure they have anti-bx started, pca's started etc...

i try to help out the overstressed floors, because that could be my family member, or me

just let nursing judgement kick in, being aware of your hospital's unique situation-----until such times as protocols are implemented

also the ASPAN website is a great resource tool--the have standards that you can order, books and other things...