The Vancouver Sedative Recovery Scale can be used to evaluate the recovery of a child following sedation. It was developed as a research tool for children following open heart surgery. It was developed at the British Columbia's Children's Hospital in Vancouver, British Columbia.
Parameters (12 items):
(A) awake-asleep: Observe child briefly. If the child is not awake, gently shake shoulder and call name up to 3 times.
(B) response to stimuli: Age-appropriate response to toy/object (recommend a noisy, bright action toy). An infant at 3 months will reach for object; an infant at 6 months will grasp object and put in mouth; after 6 months the infant will grasp the object.
(C) facial expression
(D) appearance of the eyes
(E) feeling about how the child looks at you
(F) accommodation: Looks at light or looks at finger 18 inches from nose.
(G) response to a visual stimulus
(H) eye movement: Observe movement over wide range or move to 3 different positions (at each side and at end of bed). Observe child look in 3 different quadrant positions.
(I) activity: Central involves elbow-shoulder or knee-hip. Peripheral involves hand-wrist or foot-ankle.
(J) tremor or ataxia
(K) spontaneous movement: Movement involves turning, sitting up, or reaching for object.
(L) hand movements: A 3 month old infant will grasp. A 6 month old infant will transfer the object from one hand to the other. A 9 month old infant will use a thumb and finger grasp. After 12 months the child will scribble. After 24 months the child can copy shapes. After 3 years the child can draw pictures. After 5 years the child can print or write his or her name.
|
Parameter |
Finding |
Points |
|
(A) awake-asleep |
awake and alert |
4 |
|
|
awake but drowsy |
3 |
|
|
asleep but easily aroused |
2 |
|
|
asleep and difficult to arouse |
1 |
|
|
asleep and unable to arouse |
0 |
|
(B) response to stimuli |
responds fully to stimuli in an age-appropriate manner |
2 |
|
|
delayed response to stimuli |
1 |
|
|
absent response to stimuli |
0 |
|
(C) facial expression |
"alert" |
1 |
|
|
"flat" |
0 |
|
(D) appearance of eyes |
bright eyes |
1 |
|
|
dull eyes; glazed |
0 |
|
(E) feeling how the child looks at you |
looks "at you" |
1 |
|
|
looks "through you" |
0 |
|
(F) accommodation |
accommodates |
2 |
|
|
no attempt to accommodate |
1 |
|
|
unable to accommodate |
0 |
|
(G) visual stimulus |
recognition of stimulus |
1 |
|
|
limited or no recognition of stimulus |
0 |
|
(H) eye movement |
purposeful and spontaneous |
1 |
|
|
little or no spontaneous or purposeful eye movement |
0 |
|
(I) activity |
spontaneous and varied central activity |
4 |
|
|
spontaneous and varied peripheral activity |
3 |
|
|
central activity in response to stimuli |
2 |
|
|
peripheral activity in response to stimuli |
1 |
|
|
no movement |
0 |
|
(J) tremor or ataxia |
absence of tremor or ataxia |
1 |
|
|
ataxia or tremor on being moved |
0 |
|
(K) spontaneous movement |
coordinated spontaneous movement |
2 |
|
|
weak/coarse spontaneous movement |
1 |
|
|
no purposeful spontaneous movement |
0 |
|
(L) hand movements |
shows age-appropriate manual dexterity |
2 |
|
|
awkward or clumsy hand movement |
1 |
|
|
no fine hand movement |
0 |
where:
• If the child is unrousable in step A, then no further assessment is done.
Vancouver sedative recovery scale =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score: 22
• The higher the score, the more awake and alert the patient.
Purpose: To use the Vancouver Recovery Scale to evaluate a child's recovery from sedation.
Specialty: Anesthesiology
Objective: response to therapy
ICD-10: T88.5,
