Free tool · Scored assessment · PACU / post-op
Modified Aldrete Score.
The recovery-room score for whether a post-anesthesia patient is ready to move on from PACU. Score the five domains — activity, respiration, circulation, consciousness, and oxygen saturation, each 0–2 — and get the total (max 10) with the read against the common ≥9 discharge threshold. The scoring follows the 1995 modified Aldrete system (which swapped skin color for pulse oximetry). The score is one gate among your facility's full discharge criteria — it doesn't replace them or the provider's clearance.
Score the five recovery domains
Assess the patient now and pick the best-fitting option for each. The total updates as you go.
Score all five domains to see the total and discharge read.
Scoring & discharge threshold [2]
| Domain | 2 | 1 | 0 |
|---|---|---|---|
| Activity | Moves 4 extremities | Moves 2 extremities | Cannot move |
| Respiration | Deep breathe & cough freely | Dyspnea / shallow / limited | Apneic |
| Circulation | BP ±20 mmHg of baseline | BP ±20–50 mmHg | BP >±50 mmHg |
| Consciousness | Fully awake | Arousable on calling | Not responding |
| O₂ saturation | SpO₂ >92% on room air | O₂ to keep SpO₂ >90% | SpO₂ <90% with O₂ |
Total 0–10. A score of ≥9 is a commonly used (conservative) threshold for readiness to discharge from phase I PACU; many references — including the StatPearls source cited here — accept ≥8, and a score of 8 may be acceptable when, for example, a lower BP matches the patient's own baseline.[2] (Circulation is sometimes scored as a percentage of the pre-anesthetic baseline — <20% / 20–50% / >50% — rather than in mmHg.) The Aldrete score is one component of discharge readiness — pain, nausea, surgical-site status, temperature, and a responsible escort/orders all matter too. Your facility's full discharge criteria and the provider's clearance govern.
References
- Aldrete JA, Kroulik D. A postanesthetic recovery score. Anesth Analg. 1970;49(6):924–934. PMID: 5534693. (Original five-domain recovery score, each domain 0–2, total 0–10.)
- Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89–91. PMID: 7772368; and Aldrete Scoring System. StatPearls. ncbi.nlm.nih.gov/books/NBK594237. (Modified version replaces skin color with SpO₂; domain bands and the ≥9 discharge threshold transcribed from these sources.)
- American Society of PeriAnesthesia Nurses (ASPAN) / standard PACU practice — the Aldrete score is one element of a complete discharge-criteria assessment. aspan.org.
Domain bands and the discharge threshold were transcribed from these sources. Many units use Aldrete alongside or in place of other discharge scoring (e.g., PADSS for phase II) and local criteria — those take precedence.
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