PACU bypass: Stage I bypass criteria

Discharge from PACU

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)

Adapted from Table 85-14: Criteria for Determination of Discharge Score for Release from the Postanesthesia Care UnitActivity:

• 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)