3. In post-op: Fill in this chart to factor in the length of periopera-
tive duration and blood loss.
4 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 8
Risk Factor 1 2 3 Total
Anesthesia MAC, local Regional General
Physical status
Healthy/mild disease Moderate/severe disease ASA >3
Body temp 36.1°C to 37.8° C <36.1° C or >37.8°C <36.1°C or >37.8°C
Hypotension Absent or <10%
change in BP
Fluctuating or 11% to
20% change in BP
Persistent or 21%
to 50% change in BP
Skin under patient Remains dry Some moisture Pooled or heavy fluid
Surface/motion None/use of
blanket/stationary
Use of positioning
aids/stationary
Shearing force/added
pressure/variable position
Position for procedure lithotomy lateral supine/prone
13 = low risk 14-24 = moderate risk ≥ 25 = high risk Intraop score:
Risk Factor 1 2 3 Total
Procedure length Up to 2 hours 2 to 4 hours Longer than 4 hours
Blood loss Up to 200cc 201cc to 400cc More than 400cc
Post-op score:
Pre-op/OR total:
15 = low risk 16-28 = moderate risk ≥ 29 = high risk Total risk score:
Add the post-op score to the pre-op and intraop tallies to come up
with a total risk factor score. The higher the score, the higher the risk
of a pressure ulcer developing for up to 72 hours after surgery.
The patient's final score, though it's used often in inpatient settings to
communicate risk to the continuation of care team, can also help out-
patient facilities know if a particular patient needs additional follow-up
after they return home. For example, if in the final phase you deter-
mine that there was additional risk of pressure injury on the patient's
sacrum due to being in the supine position for an extended time during
surgery, encourage early ambulation and continued efforts to reduce
pressure on that part of the body as part of the patient's post-op
instructions. Because many pressure injuries don't show up until long
