SKOR PEMULIHAN PASCA ANESTESI / PEMBEDAHAN

No. Dokumen No. Revisi Halaman

MED-PAB/Form-001 B/10-2017 1 dari 3

1. ALDRETE SCORE (DEWASA)

Aspek Parameter Skala Hasil

Pergerakan Gerak bertujuan 2
Anggota Gerak tak bertujuan 1
Badan Diam 0
Pernafasan Nafas baik, adekuat, menangis 2
Nafas depresi ringan 1
Nafas perlu dibantu 0
Sirkulasi Tekanan darah berubah dibawah 20% pre operasi 2
Tekanan darah berubah dibawah 20 – 50% pre operasi 1
Tekanan darah berubah diatas 50% pre operasi 0
Warna kulit Merah jambu 2
Pucat 1
Sianosis 0
Kesadaran Sadar penuh 2
Bereaksi 1
Tak berekasi 0
Total Nilai Nilai 9 atau lebih: Boleh pulang ke rumah dengan kondisi pembedahan / tindakan
memungkinkan atau pindah ke Ruang Perawatan
Nilai 7: Ke Ruang Perawatan, bila nilai pernafasan = 2
Nilai 5: Ke Unit Perawatan Intensif

2. STEWARD SCORE (ANAK-ANAK)

Aspek Parameter Skala Hasil

Pergerakan Gerak bertujuan 2
Anggota Gerak tak bertujuan 1
Badan Diam 0
Pernafasan Batuk, menangis 2 2
Pertahankan jalan nafas 1 1
Perlu bantuan 0
Warna kulit Merah jambu 2
Pucat 1
Sianosis 0
Kesadaran Menangis 2 2
Bereaksi terhadap rangsangan 1 1
Tidak bereaksi 0
Total Nilai

Jika jumlah > 5, pasien dapat dipindahkan ke ruangan.

3. BROMAGE SCORE (SPINAL ANESTESI)

Parameter Skala Hasil

Gerakan penuh dari tungkai, 0 0
Tak mampu ekstensi tungkai, 1 1
Tak mampu fleksi lutut, 2 2
Tak mampu fleksi pergelangan kaki, 3 3
Total Nilai
Jika Bromage Score 2 dapat pindah ke ruangan.

4. GUIDELINES FOR SAFE DISCHARGE AFTER AMBULATORY SURGERY

Result
Parameter
No Yes
Vital signs must have been stable for at least 1 h
The patient must be
 Oriented to person, place, and time
 Able to retain orally administered fluids
 Able to void
 Able to dress
 Able to walk without assistance
The patient must not have
 More than minimal nausea and vomiting
 Excessive pain
 Bleeding
The patient must be discharged by both the person who
administered anaesthesia and the person who performed surgery,
or by their designates.
Written instructions for the postoperative period at home, including
a contact place and person, must be reinforced.
The patient must have a responsible, “vested” adult escort them
home and stay with them at home.
5. POST-ANESTHESIA DISCHARGE SCORING SYSTEM (PADS) FOR
DETERMINING HOME-READINESS

Vital signs Scale Result

Vital signs must be BP and pulse within 20% of preoperative 2
stable and consistent baseline
with age and BP and pulse 20%–40% 1
preoperative baseline BP and pulse >40% of preoperative baseline 0
Activity level
Patient must be able to Steady gait, no dizziness, or meets preoperative 2
ambulate at level
preoperative level Requires assistance 1
Unable to ambulate 0
Nausea and vomiting
The patient should Minimal: successfully treated with PO medication 2
have minimal nausea Moderate: successfully treated with IM 1
and vomiting before medication
discharge Severe: continues after repeated treatment 0
Pain
The patient should have minimal or no pain before discharge
The level of pain that the patient has should be acceptable to the patient
Pain should be controllable by oral analgesics
The location, type, and intensity of pain should be consistent with
anticipated postoperative discomfort
Acceptability Yes 2
No 1
Surgical bleeding
Postoperative bleeding Minimal: does not require dressing change 2
should be consistent Moderate: up to two dressing changes required 1
with expected blood Severe: more than three dressing changes 0
loss for the procedure required
Total Score
Patients are judged fit for discharge when their score is >9