Aldrete Score Calculator determines the current health status of a patient by monitoring five of the essential Aldrete score items: mobility, blood pressure, consciousness, breathing and skin colour. It gives you the score based on evaluating the patient’s health status in the post-anesthesia phase. Additionally, besides displaying the final Aldrete score, this calculator will clarify whether the patient is ready to be discharged from the PACU or the patient still needs to be looked after with constant care.
Check out this link if you need more health-related calculators besides this calculator.
What is the Aldrete score used for?
In 1970, Jorge Antonio Aldrete and Kroulik developed a grading system for post-anesthesia scoring so that doctors could monitor patients’ recovery from anesthesia. The Aldrete score of the patient’s state was determined based on five variables: activity, respiration, circulation, consciousness, and colour. For example, if the patient scored 9 out of 10, it was considered the perfect time for discharge from the PACU (post-anesthesia care unit), which can be found in hospitals. However, since there were many advances and improvements in surgeries, the Aldrete score system got its modified version.
Why do we even need these anesthesia monitoring systems?
Suppose a patient undergo ambulatory surgery and takes some kind of surgical anesthesia. In that case, there is a chance that something can go wrong, and the patient can get into a highly complex situation with the risk of losing their own life. Thus, monitoring these anesthesia recovering phases is crucial to nullify any risks.
If a patient takes general anesthesia, we give a lot of painkillers to the patient so that he cannot move, breathe and stop any muscle activity. Therefore, PACU zones have a task to ensure that the patient regains all his essential life functions and control any side effects threats.
Each post-anesthesia recovery includes two phases:
I PACU phase: Patient’s full recovery and return of vital signs.
Possible complications of Phase I:
- Cardiovascular depression
II PACU phase: Preparing the patient before discharging him to hospital. Patients also learn to take care of themselves when discharged to their homes through an education seminar.
Possible complications of Phase II:
Types of anesthesia:
- Local anesthesia
- Regional anesthesia
- General anesthesia
Aldrete score items
There are five score items we take into consideration when processing the evaluation of patients in the following directions. These defined items help in calculating the patient’s likelihood of recovery:
- Consciousness (actively ask a patient couple of questions and checking whether the patient logically answers them in order to determine consciousness status)
- Mobility (determine whether the patient is able to move his extremities)
- Breathing (checks respiratory efficiency of the patient – respiratory effort)
- Circulation (actively comparing the patient’s systemic blood pressure before and after the surgery)
- Colour (colour skin aspect – the skin colour of the patient has to be within the normal colour range)
How to use the Aldrete score calculator?
Okay, we have explained the Aldrete score and where it is used. But, how does the Aldrete score calculator work in order to calculate the physical state of a patient after the anesthesia procedures?
In the previous chapter, we mentioned five of the score items. Going through each item, we measure the patient’s status of recovery. But, to find the Aldrete score for an individual, we need to know how to grade it using the Aldrete score chart.
Aldrete score chart
Take a look at the chart items and Aldrete score sheet down below:
|Score items||Answer choices (Points)|
|Consciousness||Not responding (0 pts)|
Arousable by calling (1 pts)
Fully awake, in full contact (2 pts)
|Mobility||Unable to move extremities (0 pts) |
Able to move 2 extremities on command (1 pts)
Able to move 4 extremities on command (2 pts)
|Breathing||Apnoeic (0 pts)|
Dyspnoea or limited breathing (1 pts)
Able to breathe deeply and cough freely (2 pts)
|Circulation||BP ±50% of pre-anesthetic level (0 pts)|
BP ±20-49% of pre-anesthetic level (1 pts)
BP ±20% of pre-anesthetic level (2 pts)
|Color||Cyanotic (0 pts)|
Pale, dusky, blotchy, jaundiced, or other (1 pts)
Normal (2 pts)
Aldrete Score interpretation
Each item from the chart can have between 0 and 2 points, depending on which option you choose for the patient. The higher score a patient has, the higher chances are of recovering from the anesthesia. For example, a score of 9 out of 10 is considered that the patient can be discharged from the PACU zone with no need of observation. In contrast, a score of 7 and below means the patient should be actively monitored because there is a higher risk of possible complications.
How to calculate the Aldrete score?
So, we know how the patient’s evaluation procedure goes, now let’s show it in the real example. We will use our calculator to calculate the Aldrete score of a patient.
- First, we check the patient readiness by choosing one of the three provided options. Let’s say we pick “Fully awake”.
- Secondly, we need to be sure if the patient can or cannot move any of his extremities. Suppose our patient can move his legs, so we choose the option “able to move 2 extremities”.
- Thirdly, we check the patient’s breathing. Let’s assume the patient has no breathing issues, so we check the option “able to breathe/cough freely”.
- Then, we check the blood pressure, and it’s “±20%”.
- Lastly, we check the patient’s skin colour. Let’s suppose our patient is a bit pale, which means that it is not in the recommended colour range.
After that, the calculator sums up all the points and gives you the Aldrete score, which is 8 in our case. A score of 8 does not meet the criteria, and we are not allowed to discharge the patient from the PACU.
After patients wake up from anesthesia, they need special treatment. Therefore, each patient’s health is monitored and checked by PACU nurses. Thus, PACU nurses have the task to track the patients’ health status, their vital signs, level of consciousness and side effects. As opposed to other work environments, they work in a pretty stressful environment with two or more patients at a time, providing them constant care. Once the patient feels better and is allowed to go home, nurses had to educate the patient’s family on what medications and pills they should give to the patient at home.
Normal Aldrete score is considered any value of 9 and above to the maximum of 10. Anything below 9 means that the patient is not in a good recovery state. Nurses should actively check on them and monitor their recovery progress.
We can read the Aldrete score by using the Aldrete score calculator. All you need to do is check on the patient, and according to his physical signs after anesthesia, you choose the options in the calculator. Grade the patient’s consciousness, mobility, breathing, blood pressure and skin colour, and the calculator will give you the final score.
In 1975, The Simplified Postanesthetic Recovery Score managed to monitor only three items: consciousness, airway, and movement. As the surgeries and types of anesthesia improved over the years, Aldrete modified the old Postanesthetic Recovery Score and introduced two more items: skin colour and blood pressure. Therefore, today in postanesthetic recoveries, all patients undergo evaluation of five score items, not three as it was the case before. Modified Aldrete Score inspects a patient’s motor activity, blood pressure, readiness, respiration, and skin colour in the post anestheisa phase.
Post anesthesia recovery score is used to evaluate patients in the Phase I, and they are evaluated until the patient scores 8 out of 10. This evaluation includes: muscle activity, respiratory efficiency, blood pressure, patient’s level of consciousness and arterial oxygen saturation.
A patient score of 8 out of 10 indicates that the patient cannot be discharged from the Post Anesthetic Care Unit (PACU).