The following articles are useful to have visible in theatre before starting a case
PARS score for in theatre discharge guidance
Post anaesthetic recovery score (PARS) discharge criteria (adult/paediatric)
Level of consciousness
|Awake / Drowsy / responds easily to voice||2|
|Responds to physical touch||1|
|Responds to painful stimuli / unconscious||0|
|Maintains own airway, coughs freely||2|
|Spontaneous breathing, may have abnormal rate||1|
|Requires airway support, dyspnoea||0|
|>= 94% on room air||2|
|>= 94% on up to 5L O2||1|
|<= 93% on any O2||0|
Vital signs (adults)
|+/- 20% of preop systolic blood pressure||2|
|+/- 20-40% preop systolic blood pressure||1|
|+/- > 40% preop systolic blood pressure||0|
or, vital signs (paediatric)
|Heart and respiratory rate above minimum but within recommended range for age||2|
|Heart and/or respiratory rate above or below minimum recommended for age||0|
Motor Movement (compared to preop state)
|Able to move all 4 limbs, normal power, and holds head off pillow for 5 seconds||2|
|Able to move two limbs with normal power||1|
|No voluntary movement||0|
Pain Score - numeric
|Patient pain score 0-3||2||(none to slight)|
|Patient pain score 4-5||1||(slight to mild)|
|Patient pain score 6-10||0||(moderate to severe)|
or Pain Score - FLACC Scale
|Patient FLACC score 0-3||2||(none to slight)|
|Patient FLACC score 4-5||1||(slight to mild)|
|Patient FLACC score 6-10||0||(moderate to severe)|
Post Operative Nausea and Vomiting
|No to slight nausea and no vomiting||2|
|Transient nausea with vomiting||1|
|Persistent nausea and vomiting||0|
Discharge without Anaesthetist Consent permissible if:
- The patient scores 12 or greater (see PARS discharge criteria above).
- The patient has no '0' scores using the above criteria.
- Temperature is >36° and <38°.
- Observations have remained stable and there are no areas of patient concern or an expected deterioration.
- 30 minutes has elapsed since last intravenous narcotic titration has been administered.
- Oxygen is discontinued 10 minutes prior to discharge to assess oxygen requirements.
- All intravenous cannulas have been flushed and arterial line have been removed if not going to ERU I CCUl I HDU / ICU, Delivery Suite HDU.
- IV fluids, oxygen, analgesia, naloxone (if required), anti-emetics, laxatives and VTE are prescribed.
- Notation is made of drugs administered intra-operatively on the patient's National Medication Chart
- Post - surgical criteria have been met.