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The following articles are useful to have visible in theatre before starting a case

Surgical Safety Checklists

surgical safety checklist posters Jun 2015 1

surgical safety checklist posters Jun 2015 2

surgical safety checklist posters Jun 2015 3

surgical safety checklist posters Jun 2015 4

 

 

 

 

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  

Airway

   
Maintains own airway, coughs freely 2  
Spontaneous breathing, may have abnormal rate 1  
Requires airway support, dyspnoea 0  

Oxygen saturation

   
>= 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.