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PACU Discharge & Aldrete Score

Modified Aldrete study guidance, Phase I → Phase II considerations, and a policy-aware transition checklist.

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Modified Aldrete (study the facility-approved version)

Activity: 2 = moves 4 extremities · 1 = moves 2 · 0 = moves none
Respiration: 2 = breathes deeply, coughs freely · 1 = dyspnea/shallow · 0 = apneic
Circulation: 2 = BP ±20% of baseline · 1 = ±20–50% · 0 = ±50%
Consciousness: 2 = fully awake · 1 = arousable · 0 = not responding
O2 saturation: 2 = >92% on room air · 1 = needs O2 to keep >90% · 0 = <90% with O2

Airway: Patent, protecting own airway, no stridor, no snoring apnea
Pain: Controlled and reassessed after the last dose — not just "medicated"
PONV: No active vomiting; antiemetic given and effective
Bleeding: Dressing marked and dry, drains documented, no expanding hematoma
Block: Level documented if regional/neuraxial; sensory level receding
Lines/labels: IV patent, correct fluids, pumps labeled
Report: Receiving RN has SBAR + last dose times + orders that are still pending

Respiratory: RR <8, needs jaw thrust, or repeated desats off stimulation
Hemodynamics: New pressor need, unexplained tachycardia, ongoing bleeding
Neuro: Not back to baseline mentation, new deficit
Temperature: Outside the ordered/facility readiness range, symptomatic, or not responding to warming

✦The opioid you gave 5 minutes before transport peaks in the elevator. Time your last dose.
✦OSA, sedating medication, recurrent obstruction, or rising oxygen need may require extended monitoring under the ordered/local pathway.
✦Score the patient, don't score the clock.
✦A score supports—but never independently authorizes—transfer or discharge. Follow current orders and facility policy.

Educational reference only. Always follow your facility's current policies, protocols, and provider orders.

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