Summary of Recommendations for Assessment and Monitoring

Source: Adapted from Practice Guidelines for Post Anesthetic Care: A report by the American Society of Anesthesiologists Task Force on Post Anesthetic Care. Anesthesiology 2002; 96:742-752.

Summary of Recommendations for Discharge

1. Requiring that patients urinate before discharge.

Don�t make the requirement for urination before discharge part of a routine discharge protocol; it may be necessary only for selected patients.

2. Requiring that patients drink clear fluids without vomiting before discharge.

Don�t make the demonstrated ability to drink and retain clear fluids part of a routine discharge protocol, but it may be appropriate for selected patients.

3. Requiring that patients have a responsible individual accompany them home.

You routinely should require patients, as part of a discharge protocol, to have a responsible individual accompany them home.

4. Requiring a minimum mandatory stay in recovery.

Don�t require a mandatory minimum stay.

Observe patients until they are no longer at increased risk of cardiorespiratory depression.

Design discharge criteria to minimize the risk of central nervous system or cardiorespiratory depression after discharge.

Source: Adapted from Practice Guidelines for Post Anesthetic Care: A report by the American Society of Anesthesiologists Task Force on Post Anesthetic Care. Anesthesiology 2002; 96:742-752.

Summary of Recovery and Discharge Criteria

General principles

• Medical supervision of recovery and discharge is the responsibility of the supervising practitioner.
• The recovery area should be equipped with appropriate monitoring and resuscitation equipment.
• Patients should be monitored until appropriate discharge criteria are satisfied.
• Level of consciousness, vital signs, and oxygenation (when indicated) should be recorded at regular intervals.
• A nurse or other individual trained to monitor patients and recognize complications should be in attendance until discharge criteria have been fulfilled.
• An individual capable of managing complications should be immediately available until discharge criteria are fulfilled.

Guidelines for discharge

• Patients should be alert and oriented. Patients whose mental status was initially abnormal should have returned to their baseline.
• Vital signs should be stable and within acceptable limits.
• Discharge should occur after patients have met specified criteria. Use of scoring systems may assist in documentation of fitness for discharge.
• Outpatients should be discharged to a responsible adult who will accompany them home and be able to report any post-procedure complications.
• Outpatients should be provided with written instructions regarding post-procedure diet, medications, activities, and a phone number to be called in case of emergency.

Source: Adapted from Practice Guidelines for Post Anesthetic Care: A report by the American Society of Anesthesiologists Task Force on Post Anesthetic Care. Anesthesiology 2002; 96:742-752.