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 |
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| Awake / Drowsy / responds easily to voice | 2 | |
| Responds to physical touch | 1 | |
| Responds to painful stimuli / unconscious | 0 | |
Airway |
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| Maintains own airway, coughs freely | 2 | |
| Spontaneous breathing, may have abnormal rate | 1 | |
| Requires airway support, dyspnoea | 0 | |
Oxygen saturation |
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| >= 94% on room air | 2 | |
| >= 94% on up to 5L O2 | 1 | |
| <= 93% on any O2 | 0 | |
Vital signs (adults) |
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| +/- 20% of preop systolic blood pressure | 2 | |
| +/- 20-40% preop systolic blood pressure | 1 | |
| +/- > 40% preop systolic blood pressure | 0 | |
or, vital signs (paediatric) |
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| 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) |
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| 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 |
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| 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 |
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| 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 |
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| 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.