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[Paediatric discharge score in ambulatory surgery]
S Biedermann1, E Wodey1, F De La Brière1
1Pôle anesthésie SAMU urgences réanimations, hôpital Sud, université de Rennes, 116, boulevard Bulgarie, 35203 Rennes cedex 2, France.
Insights
The Pediatric Post-Anesthetic Discharge Scoring System (Ped-PADSS) effectively assesses readiness for discharge in pediatric surgical patients. Most children met discharge criteria within two hours, suggesting reduced hospital stays.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Patient Safety
Context:
- Outpatient surgery requires standardized discharge criteria.
- The Post-Anesthetic Discharge Scoring System (PADSS) is validated for adults.
- Pediatric adaptation of PADSS (Ped-PADSS) needs evaluation.
Purpose:
- To evaluate the pediatric adaptation of the Post-Anesthetic Discharge Scoring System (Ped-PADSS).
- To assess the safety and efficacy of Ped-PADSS for discharging pediatric surgical patients.
Summary:
- A prospective, observational study evaluated the Ped-PADSS in 150 ambulatory pediatric patients.
- The Ped-PADSS, based on hemodynamics, awakening, nausea, pain, and bleeding, showed high agreement with clinical discharge decisions.
- Ninety-five percent of patients achieved a Ped-PADSS score of ≥9 after two hours of monitoring.
Impact:
- The Ped-PADSS facilitates safe discharge for the majority of pediatric surgical patients.
- Implementation of Ped-PADSS may reduce the duration of hospital stays in ambulatory surgical units.
- Standardized scoring systems enhance patient safety and optimize resource utilization in pediatric ambulatory care.
Background:
In adults, the Post-Anesthetic Discharge Scoring System (PADSS) was built to secure the discharge after outpatient surgery. We evaluate a pediatric adaptation: the Pediatric-PADSS (Ped-PADSS).
Study Design:
Prospective cohort.
Methods:
This was a prospective, observational, monocentric study for ambulatory patients. Ped-PADSS is built on 5 items each quoted 0, 1, or 2: hemodynamics, state of awakening, nausea/vomiting, pain and bleeding. A result ≥9/10 validated discharge if the anesthetist did not wish to review the patient, if the parents did not wish to revisit the anesthetist or if there was no hoarseness or dyspnea. The discharge was validated by the anesthetist and the surgeon. Ped-PADSS was made without the knowledge of the nursing team, one hour after return in service and repeated hourly. Addition of patient demographic data, the collection included the hours of leave by the anesthetist, surgeon and Ped-PADSS, the duration of hospital stay post procedure.
Results:
On 150 patients, 148 patients were allowed to go out with the Ped-PADSS, one patient was released despite a Ped-PADSS<9. One patient was hospitalized for a surgical bleeding in agreement with the anesthetist, surgeon and the Ped-PADSS. Ninety-five percent of patients had a Ped-PADSS ≥9 after 2hours monitoring in the ambulatory unit.
Conclusion:
The majority of the children have met the criteria for discharge at the end of 2hours postoperative monitoring. The use of this score could reduce the hospitalization time in ambulatory unit.
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