The ASA grading standard provides anesthesiologists with a convenient reference tool to help assess a patient's physical condition and risks prior to performing surgical anesthesia. The anesthesiologist should formulate an appropriate anesthesia plan according to the actual situation of the patient and the ASA grading standard to ensure the safety of the patient.
So, what are the specific grading criteria?
Class I: Normal healthy people. No organic, physiological, biochemical or psychiatric disorders.
Grade II: Minor systemic illness with good compensatory function. Concomitant systemic illness without functional limitations. Examples: well-controlled hypertension; Uncomplicated diabetes.
Grade III: Has a severe systemic illness with limited daily activities, but is not incapacitated and is still compensated. With severe systemic disease, functional insufficiency has developed. Examples: diabetes mellitus with vascular complications; History of previous myocardial infarction.
Grade IV: have a severe systemic disease, have lost the ability to work, and the body has compensatory insufficiency. It is accompanied by a serious systemic disease, often life-threatening.
Examples: congestive heart failure; Unstable angina.
Grade V: A near-death patient whose condition is critical and life-sustaining. Dying patients, with or without surgery, have no hope of saving their lives.
Examples: ruptured aorta; Intracranial hemorrhage with intracranial hypertension.
Grade VI: Confirmed brain death and whose organs are intended for organ transplantation.
For example, ASA1E patients with brain death can be classified as grade VI; Another example is brain death in healthy patients.
It can be seen that most of the patients are easily seated. However, there is one category of patients whose boundaries are blurred. This part of the patients is pregnant women. Many times, anesthesiologists will classify a pregnant woman as Class I.
In practice, in order to protect themselves, some anesthesiologists will set the grade as high as possible. For example, a patient's condition can be grade II or grade III, and it will eventually be classified as grade III. Because, if the setting is low, once there is a problem, it may be considered that the technology is not precise or the responsibility for the error is greater.
If the patient is pregnant, this is indeed a difficult problem. If there are no complications or accidents, everyone will take the safety of surgical anesthesia for granted. Once there is a problem, the patient is completely not responsible, it is the responsibility of the hospital.
However, friends who often do obstetric anesthesia know that no obstetric anesthesia is easy. It may not be until the patient is out of the operating room that there may be real peace of mind.
The good news is that the United States Society of Anesthesiologists Strength Status (ASA PS) classification system gives anesthesiologists a friendly reference:
In this classification system, pregnant women are clearly classified in ASAII.
The full table is as follows:
The abbreviations involved have the following meanings:
It can be seen that normal pregnancies are indeed classified in the ASAII class. The reason is that "although pregnancy is not a disease, the physiological state of pregnant women is significantly different from that of non-pregnant women, so for uncomplicated pregnant women, it is classified as ASA II".
With this, I believe that the anesthesia comrades-in-arms can at least designate all pregnant women as ASAII.
However, we must remind that this classification system is a way to assess the overall health of a patient. Specific anesthetic or surgical risks should also be assessed from the specific risks involved. However, for pregnant women, the new assessment method is friendly to anesthesiologists. At the very least, when communicating with the family before the operation, we can reasonably communicate with the family about the potential risks.
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