Everyday patients and their parents ask us, “When do we get to go home?” Whether your child is being discharged home or admitted to the hospital after surgery, there are a number of factors that go into answering this question.
Many PACUs (Post-Anesthesia Care Units), will used what is called an Aldrete score. This score is used by PACU nurses to help determine when patients can be safely discharged. The score is done immediately upon arrival to PACU and every 15 minutes until discharge. It is based on the medical staff doing an assessment of 5 areas and giving each of them a score of 0, 1, or 2 :
- Consciousness – staff look at a patient’s alertness and ability to answer questions.
- Mobility – Muscle activity is assessed by observing the patient’s ability to move their arms and leg by themselves or when asked to. *This is especially important in evaluating patients who many have had some form of block as part of their anesthesia.
- Respiration – Assessment of how well the patient is breathing.
- Circulation – Evaluated by blood pressure as compared to the preanesthetic blood pressure.
- Color – Objective evaluation of the patient’s skin color.
There is usually no standard length of time that a patient must be in the PACU. It depends on many things including the type of surgery, anesthetic used, and patient’s condition.
Most pediatric hospitals and surgery centers don’t have the requirement that patients need to eat, drink, or void before being discharged from the PACU whether to the floor or to home. Patients are usually ready to be discharged when they have an Aldrete score of 8-10, are having minimal vomiting, appropriate dressing/wound condition, and stable vital signs.
Your child might be ready to go home fairly quickly after they are awake or they might be in the PACU for a longer period of time – it is often hard to predict as every patient reacts differently to anesthesia. Lastly, in most facilities, it is the anesthesiologist who makes the final determination that a patient is ready to be discharged.
And – as always, if you know someone who is having surgery or is looking for resources to prepare for medical encounters, please send them our way.