The Post-Anesthetic Discharge Scoring System (PADSS) can be used to determine if a patient who has undergone ambulatory surgery is fit for discharge. This was developed at the Toronto Hospital, Toronto Western Division, in Canada.
Parameters:
(1) vital signs (blood pressure, heart rate, respiratory rate and temperature)
(2) activity and mental status
(3) pain, nausea and/or vomiting
(4) surgical bleeding
(5) intake and output
|
Parameter |
Finding |
Points |
|
vital signs |
within 20% of preoperative value |
2 |
|
|
20-40% of preoperative value |
1 |
|
|
> 40% of preoperative value |
0 |
|
activity and mental status |
oriented x3 AND has a steady gait |
2 |
|
|
oriented x3 OR has a steady gait |
1 |
|
|
neither oriented x3 nor steady gait |
0 |
|
pain, nausea and/or vomiting |
minimal |
2 |
|
|
moderate, having required treatment |
1 |
|
|
severe, requiring treatment |
0 |
|
surgical bleeding |
minimal |
2 |
|
|
moderate |
1 |
|
|
severe |
0 |
|
intake and output |
has had PO fluids AND voided |
2 |
|
|
has had PO fluids OR voided |
1 |
|
|
neither PO fluids nor voided |
0 |
post-anesthetic discharge score =
= SUM(points for the 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >=9 is sufficient for discharge.
Clinical Discharge Criteria (CDC):
(1) stable vital signs
(2) patient is alert and oriented
(3) patient is free of nausea and/or vomiting
(4) steady of gait
(5) patient has no significant bleeding
Qualifications for discharge:
(1) post-operative discharge score >= 9
(2) presence of a competent adult to accompany the patient home
All patients were interviewed by telephone at 24 hours after discharge using a standardized interview form. This is intended to
(1) document the post-operative course of the patient
(2) detect delayed complications after discharge
Purpose: To use the Post-Anesthesia Discharge Scoring System (PADSS) to determine if a patient who has just had ambulatory surgery is fit for discharge.
Specialty: Anesthesiology
Objective: selection
ICD-10: T88.5,
