Speeds Criteria vs. Modified Aldrete and Fast-Track Criteria for Evaluating Recovery in Outpatients

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 /span> 0.0429 modified Aldrete vs. SPEEDS, p /span> 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 /span> 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 /span> 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.