Spinal level for discharge to the floor?

Specialties PACU

Published

  • Specializes in PACU,Trauma ICU,CVICU,Med-Surg,EENT.

What is the discharge criteria in your PACU for discharge to the floor (not home)?

Currently,our policy is muddied to say the least,with every anesthetist having a different opinion:

-some say spinal has to be completely gone,evidenced by pt's ability to flex knee and lift hips off bed.

-others say as long as there is evidence that spinal is moving down,as evidenced by changing dermatomes,and vital signs are stable,the pt may be discharged.

The problem is that we do see hypotensive events even after the first 30 minutes,(and even after spinal is L4 or 5). We're concerned about this happening on the ward,where busy nurses, with several pts, may not pick up on it for awhile.

What are your thoughts?

Thanks!

nickola

250 Posts

most of our MDAs are fine w/evidence of spinal moving down & our med-surg floor is used to receiving spinals & closely monitor their VS until spinal is worn off.

Hopecascade

37 Posts

Specializes in Post-Anesthesia Care.

Two dermatone levels from initial assessment. They are all ready in a bed and are transferred to the floor. If they are SDS they must be able to stand to get into a wheelchair. They must void in SDS. I hope this helps

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