TITLE:
Speeds Criteria vs. Modified Aldrete and Fast-Track Criteria for Evaluating Recovery in Outpatients
AUTHORS:
Brent Burke, Mark Kyker
KEYWORDS:
Phase I Bypass; Fast Track; PACU Nursing Interventions
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.7,
August
16,
2013
ABSTRACT: Background: The
authors have developed criteria utilizing the mnemonic “SPEEDS” (saturation,
pain, extremity movement, emesis, dialogue, stable vitals signs) to evaluate
and predict which patients would not require phase I nursing intervention and could transition
to phase II recovery. Methods: Seventy-three
adult surgery patients underwent a standardized general anesthetic. Patients
were evaluated with the modified Aldrete, Fast-Track and SPEEDS criteria
immediately before leaving the OR and then 5, 10, 15 and 30 minutes after
arrival in the recovery area. Results: Significantly more patients met phase I bypass criteria when evaluated with
Modified Aldrete (90%) and Fast-Track (94%) as compared to SPEEDS (77%) (p 0.0429 modified Aldrete vs. SPEEDS, p 0.0038 Fast-Track vs. SPEEDS). However, SPEEDS was more sensitive having
a lower number of patients meeting phase II criteria yet requiring phase I intervention (32%) vs. Fast-track (43%)
and Modified Aldrete (44%) (p 0.001 SPEEDS vs. modified Aldrete and
Fast-Track). SPEEDS was more accurate (74%) in predicting which patients should
move directly to phase II compared to modified Aldrete (42%) (p 0.001) and Fast-track (59%) (p = 0.05). Conclusion: SPEEDS criteria are as specific and more sensitive in determining phase I nursing interventions for
ambulatory surgery patients when compared to Fast-Track and modified Aldrete
criteria.