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    ASA Physical Status Classification System 2019

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    hquinar
    The ASA Physical Status Classification System has been used for over 60 years to assess and communicate a patient's medical comorbidities prior to anesthesia. The system alone does not predict perioperative risks but can help when considered with other factors. It defines 6 classification levels from A (healthy patient) to E (emergency surgery). In 2019, the ASA added examples to better illustrate each level and improve consistency in assignments. The examples address common adult conditions and may not apply to pediatrics or obstetrics. The final classification is determined by the anesthesiologist on the day of surgery.

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    ASA Physical Status Classification System 2019

    Uploaded by

    hquinar
    94 views2 pages
    The ASA Physical Status Classification System has been used for over 60 years to assess and communicate a patient's medical comorbidities prior to anesthesia. The system alone does not predict perioperative risks but can help when considered with other factors. It defines 6 classification levels from A (healthy patient) to E (emergency surgery). In 2019, the ASA added examples to better illustrate each level and improve consistency in assignments. The examples address common adult conditions and may not apply to pediatrics or obstetrics. The final classification is determined by the anesthesiologist on the day of surgery.

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    The ASA Physical Status Classification System has been used for over 60 years to assess and communicate a patient's medical comorbidities prior to anesthesia. The system alone does not predict perioperative risks but can help when considered with other factors. It defines 6 classification levels from A (healthy patient) to E (emergency surgery). In 2019, the ASA added examples to better illustrate each level and improve consistency in assignments. The examples address common adult conditions and may not apply to pediatrics or obstetrics. The final classification is determined by the anesthesiologist on the day of surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    94 views2 pages

    ASA Physical Status Classification System 2019

    Uploaded by

    hquinar
    The ASA Physical Status Classification System has been used for over 60 years to assess and communicate a patient's medical comorbidities prior to anesthesia. The system alone does not predict perioperative risks but can help when considered with other factors. It defines 6 classification levels from A (healthy patient) to E (emergency surgery). In 2019, the ASA added examples to better illustrate each level and improve consistency in assignments. The examples address common adult conditions and may not apply to pediatrics or obstetrics. The final classification is determined by the anesthesiologist on the day of surgery.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ASA Physical Status Classification System

    Committee of Oversight: Economics

    (Approved by the ASA House of Delegates on October 15, 2014, and last amended on
    October 23, 2019)

    The ASA Physical Status Classification System has been in use for over 60 years. The purpose of
    the system is to assess and communicate a patient’s pre-anesthesia medical co-morbidities. The
    classification system alone does not predict the perioperative risks, but used with other factors (eg,
    type of surgery, frailty, level of deconditioning), it can be helpful in predicting perioperative risks.

    The definitions and examples shown in the table below are guidelines for the clinician. To improve
    communication and assessments at a specific institution, anesthesiology departments may choose
    to develop institutional-specific examples to supplement the ASA-approved examples.

    The examples in the table below address adult patients and are not necessarily applicable to
    pediatric or obstetric patients.

    Assigning a Physical Status classification level is a clinical decision based on multiple factors.
    While the Physical Status classification may initially be determined at various times during the
    preoperative assessment of the patient, the final assignment of Physical Status classification is made
    on the day of anesthesia care by the anesthesiologist after evaluating the patient.

    Current Definitions and ASA-Approved Examples

    ASA PS Definition Adult Examples, Including, but not Limited


    Classification to:
    A normal healthy patient Healthy, non-smoking, no or minimal alcohol
    ASA I use
    A patient with mild systemic Mild diseases only without substantive
    disease functional limitations. Examples include (but not
    ASA II limited to): current smoker, social alcohol
    drinker, pregnancy, obesity (30<BMI<40), well-
    controlled DM/HTN, mild lung disease
    A patient with severe Substantive functional limitations;
    systemic disease One or more moderate to severe diseases.
    Examples include (but not limited to): poorly
    controlled DM or HTN, COPD, morbid obesity
    ASA III
    (BMI ≥40), active hepatitis, alcohol dependence
    or abuse, implanted pacemaker, moderate
    reduction of ejection fraction, ESRD undergoing
    regularly scheduled dialysis, premature infant

    1
    PCA < 60 weeks, history (>3 months) of MI,
    CVA, TIA, or CAD/stents.

    A patient with severe Examples include (but not limited to): recent (<3
    systemic disease that is a months) MI, CVA, TIA, or CAD/stents, ongoing
    constant threat to life cardiac ischemia or severe valve dysfunction,
    ASA IV
    severe reduction of ejection fraction, sepsis, DIC,
    ARD or ESRD not undergoing regularly
    scheduled dialysis
    A moribund patient who is Examples include (but not limited to): ruptured
    not expected to survive abdominal/thoracic aneurysm, massive trauma,
    ASA V without the operation intracranial bleed with mass effect, ischemic
    bowel in the face of significant cardiac pathology
    or multiple organ/system dysfunction
    A declared brain-dead
    patient whose organs are
    ASA VI
    being removed for donor
    purposes

    *The addition of “E” denotes Emergency surgery:


    (An emergency is defined as existing when delay in treatment of the patient would lead to a significant
    increase in the threat to life or body part)

    References
    For more information on the ASA Physical Status Classification system and the use of examples,
    the following publications are helpful. Additionally, in the reference section of each of the
    articles, one can find additional publications on this topic.

    1. Abouleish AE, Leib ML, Cohen NH. ASA provides examples to each ASA physical
    status class. ASA Monitor 2015; 79:38-9
    http://monitor.pubs.asahq.org/article.aspx?articleid=2434536

    2. Hurwitz EE, Simon M, Vinta SR, et al. Adding examples to the ASA-Physical Status
    classification improves correct assignments to patients. Anesthesiology 2017; 126:614-22

    3. Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status – historical


    perspectives and modern developments. Anaesthesia 2019; 74:373-9

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