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ASA Physical Status Classification System
The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added. These are: #Healthy person. #Mild systemic disease. #Severe systemic disease. #Severe systemic disease that is a constant threat to life. #A moribund person who is not expected to survive without the operation. #A declared brain-dead person whose organs are being removed for donor purposes. If the surgery is an emergency, the physical status classification is followed by "E" (for emergency) for example "3E". Class 5 is usually an emergency and is therefore usually "5E". The class "6E" does not exist and is simply recorded as class "6", as all organ retrieval in brain-dead patients is done urgently. The original definition of emergency in 1940, when ASA classification was first designed, was "a surgical procedure which ...
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Surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually spa ...
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Emery Andrew Rovenstine
Emery Andrew Rovenstine (July 20, 1895 – November 9, 1960) was an American anesthesiologist best known for organizing the first academic Department of Anesthesiology at New York's Bellevue Hospital. He also helped develop the anesthetic use for the gas cyclopropane, and he was a pioneer in therapeutic nerve blocking. Upon his death in 1960, the New York Times proclaimed him "one of the world's foremost anesthesiologists." Early life Dr. Rovenstine was born in 1895, in Atwood, Indiana, where he clerked at his father's grocery store. He briefly attended Winona College in nearby Winona Lake and taught high school before moving on to Wabash College, where he was graduated in 1917. Upon graduation, Rovenstine enlisted in the Army and served in France during World War I. During his three years of active duty, much of which he spent in charge of an engineering demolition squad, he witnessed battlefield pain and suffering which inspired him to pursue a career in medicine. Medical ...
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Anesthesia
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of procedures that would otherwise cause severe or intolerable pain in a non-anesthetized individual, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist: * General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled drugs. * Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. * Regional and local anesthesia, which blo ...
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:Category:Medical Scales
Medical scales are scales used to describe or assess medical conditions. {{commonscat, Medical scales Scales Scales Scale or scales may refer to: Mathematics * Scale (descriptive set theory), an object defined on a set of points * Scale (ratio), the ratio of a linear dimension of a model to the corresponding dimension of the original * Scale factor, a number w ...
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Perioperative Mortality
Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks. Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available. ASA score is the most well known of these. Intraoperative causes Immediate complications during the surgical procedure, e.g. bleeding or perforation of organs may have lethal sequelae. Complications following surgery Infection Countries with a low human development index (HDI) carry a disproportionately greater burden of surgical site infections (SSI) than countries with a middle or high HDI and might have higher rates of antibiot ...
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BIS Monitor
Bispectral index (BIS) is one of several technologies used to monitor depth of anesthesia. BIS monitors are used to supplement Guedel's classification system for determining depth of anesthesia. Titrating anesthetic agents to a specific bispectral index during general anesthesia in adults (and children over 1 year old) allows the anesthetist to adjust the amount of anesthetic agent to the needs of the patient, possibly resulting in a more rapid emergence from anesthesia. Use of the BIS monitor could reduce the incidence of intraoperative awareness during anaesthesia. The exact details of the algorithm used to create the BIS index have not been disclosed by the company that developed it. BIS cannot be used as the sole monitor of anaesthesia, as it is affected by several other factors, including the anaesthetic drugs used (BIS is relatively insensitive to agents such as ketamine and nitrous oxide), and muscle movement or artefact from surgical equipment. BIS is used as an adjunct t ...
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Anesthetics
An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness. A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside anesthesiology, but others are used commonly in various fields of healthcare. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects. Adverse effects, however, may also be increased. Anesthetics are distinct from analgesics, which block only sensation of painful stimuli. Local anesthetics Local anesthetic agents prevent the transmission of nerve impulses without causi ...
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Anesthetic Equipment
Following is a list of instruments used in the practice of anesthesia __TOC__ Instrument list Anesthetic machine General anesthesia does not always require the anesthetic machine, tested daily, as basic equipment. Anesthesia machines may differ in appearance, size and degree of sophistication but generally speaking, they consist of sections for: * ventilation * Peripheral Nerve Stimulator * space for monitoring equipment * accessories * storage space * worktop It is imperative that essential medical pipeline gas supply, ''e.g.'' oxygen], nitrous oxide and air, are secured firmly to the machine, and readily available without any obstructions, defects or pressure leaks. They should also be checked in between cases, ensuring that the breathing apparatus and breathing circuit are fully patent, for the safe anesthesia of patients. Major manufacturers of anesthetic machines are General Electric (GE), Larsen & Toubro Limited, Draeger and MAQUET. Image gallery Image:Bag valve mask.jpg ...
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Anesthetic Agents
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of procedures that would otherwise cause severe or intolerable pain in a non-anesthetized individual, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist: * General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled drugs. * Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. * Regional and local anesthesia, which blocks ...
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Comorbidity
In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often wikt:co-occur#Verb, co-occurring (that is, wikt:concomitant#Adjective, concomitant or wikt:concurrent#Adjective, concurrent) with a primary condition. Comorbidity describes the effect of all other conditions an individual patient might have other than the primary condition of interest, and can be physiological or psychological. In the context of mental health, comorbidity often refers to Mental disorder, disorders that are often coexistent with each other, such as Major depressive disorder, depression and Anxiety disorder, anxiety disorders. The concept of multimorbidity is related to comorbidity but presents a different meaning and approach. Definition The term "comorbid" has three definitions: # to indicate a medical condition existing simultaneously but independently with another condition in a patie ...
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American Society Of Anesthesiologists
The American Society of Anesthesiologists (ASA) is an educational, research and scientific association of physicians organized to raise the standards of the medical practice of anesthesiology and to improve patient care. As of 2021, the organization included more than 55,000 national and international members and has more than 100 full-time employees. History Anesthesiology's roots date back to the mid-19th century. On March 30, 1842, Crawford Long, M.D. administered the first ether anesthetic for surgery and operated to remove a tumor from a patient's neck. After the surgery, the patient revealed that he felt nothing and was not aware the surgery was over until he awoke. This was the start of a specialty critical to modern medicine, anesthesiology. In 1905, nine physicians (from Long Island, N.Y.) organized the first professional anesthesia society. In 1911, the Society expanded to 23 members and became the New York Society of Anesthetists. Over the next 25 years, involvement in ...
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Emergency
An emergency is an urgent, unexpected, and usually dangerous situation that poses an immediate risk to health, life, property, or environment and requires immediate action. Most emergencies require urgent intervention to prevent a worsening of the situation, although in some situations, mitigation may not be possible and agencies may only be able to offer palliative care for the aftermath. While some emergencies are self-evident (such as a natural disaster that threatens many lives), many smaller incidents require that an observer (or affected party) decide whether it qualifies as an emergency. The precise definition of an emergency, the agencies involved and the procedures used, vary by jurisdiction, and this is usually set by the government, whose agencies (emergency services) are responsible for emergency planning and management. Defining an emergency An incident, to be an emergency, conforms to one or more of the following, if it: * Poses an immediate threat to life, hea ...
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