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Safe discharge from recovery (General criteria (suitable for ward…
Safe discharge from recovery
General criteria (suitable for ward discharge)
Safe, appropriate and willing discharge destination
Anaesthetic - Stable vital signs
Breathing: RR 8-16, adequate, non obstructed, well oxygenated
Circulation: rate, rhythm acceptable, BP acceptable
Awake and orientated
Airway:able to cough, clear airway
Minimal risk of post op airway compromise
Pain manageable with techniques available on ward
PONV well controlled
TEMP 36-38
Documentation complete and relevant handover
Surgical
Minimal risk of post op haemorrhage - if high risk consider HDU/ICU
Documentation complete and relevant handover
On discharge
Written instruction including
Eating and drinking or fluid/feeding plan
Pain relief
Advice on resumption of normal activities
Resumption of making legally binding decisions, driving or operating maschinery
Contact numbers provided
System should be in place to enable safe transfer of patient to appropriate medical care should the need arise
Discharge home form recovery
Patient
Willing patient, able to understand and follow discharge instructions
Discharge into care of responsible adult
Within 1hr of appropriate medical attention
ASA I or II or stable III or IV, deemed appropriate by anaesthetist
Specific arrangements for paeds (Normal term infant > 6weeks, Ex prem infant > 52 weeks post conceptual age). Mitigates against post op apnoea risk
Anaesthetic
Minimise risk of post op airway compromise
Stable vital signs
Pain manageable with outpatient techniques
Rapid return to normal fluid and food intake
Awake, alert, orientated
Ambulant
Surgery
Minimal risk of post op haemorrhage
Post op care manageable by patient and/or adult and outpatient nursing
Operative list organised so early commencement of procedures if long recovery period likely
List of normal and abnormal symptoms which may present post op at home
Reason for unplanned admission after surgery
Pre anaesthetic consult should illicit if unlikely to fulfil above criteria
Do not fulfil discharge criteria before unit closes
Observation after surgical and anaesthetic complication
Unexpectedly more extensive surgery
Inadequate social circumstances
Uncontrolled pain, PONV or not ambulant