Operating Room Recovery (PACU)
A room type built entirely around the first hour after anesthesia.
Purpose of the space
The post-anesthesia care unit catches and reverses complications that show up in the first minutes after surgery: airway compromise, hemodynamic instability, uncontrolled pain, nausea. Everything about the room — open bays, high nurse-to-patient ratios, continuous monitoring, immediate access to code equipment — flows from that purpose.
Discharge scoring
The Modified Aldrete Score is the most common bedside criterion in Phase I PACU. Score ≥ 9 typically permits discharge to Phase II or a floor bed.
| Domain | 2 | 1 | 0 |
|---|---|---|---|
| Activity | Moves 4 extremities | Moves 2 | Moves 0 |
| Respiration | Deep breath / cough | Dyspnea / limited | Apnea |
| Circulation | BP ±20% pre-op | ±20–50% | ±50%+ |
| Consciousness | Fully awake | Arousable | Not responding |
| SpO2 | ≥ 92% on room air | Needs O2 to keep ≥ 90% | < 90% with O2 |
Standards
- ASA Standards for Postanesthesia Care.
- ASPAN Perianesthesia Nursing Standards.
- FGI Guidelines — Post-anesthesia Care Unit clearance and spacing.
References & further reading
- 1American Society of Anesthesiologists — Standards for Postanesthesia Care
- 2American Society of PeriAnesthesia Nurses — Perianesthesia Nursing Standards
- 3FGI Guidelines for Design and Construction of Hospitals
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