Following sedation or anesthesia for ambulatory surgery it is important to have criteria for discharging patients so as to make sure that they are not released prematurely or in an unstable condition. This is particularly true when the sedation is performed in the outpatient or office setting.


Discharge Criteria


(1) Vital signs and oxygen saturation are stable for a sufficient period of time, typically at least 1 hour.


(2) All reflexes (gag, swallowing, cough) are completely recovered. Baseline motor function is appropriate for age.


(3) Nausea, vomiting and dizziness are minimal.


(4) The patient is oriented to person, place and time. The patient recognizes and interacts with others.


(5) If the patient can follow commands and verbalize, then the patient should be able to follow commands and verbalize appropriately (may not apply to an infant).


(6) The patient is alert, active and can sit unaided.


(7) If the patient can walk, then the patient should be able walk without assistance (may not apply to an infant). The patient should be able to walk without a sense of dizziness, blurring of vision or nystagmus.


(8) Hydration is adequate, and the patient is able to take liquids (may not apply to an infant).


(9) The patient is discharged into the care of a competent adult, parent or guardian.


(10) The patient or caregiver is provided with post-operative instructions and a 24 hour emergency contact number. Follow-up by telephone or a visiting nurse is recommended.


(11) The patient should be able to void after (a) genitourinary or gynecologic procedure, or (b) spinal or epidural anesthesia.


(12) Absence of excessive pain.


(13) No significant bleeding.


(14) No evidence of respiratory distress (snoring, stridor, retractions, nasal flaring, barky cough, wheezing, cyanosis or dyspnea).


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