ASA

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  • ASA I
  • A normal healthy patient
  • ASA II
  • Healthy, non-smoking, no or minimal alcohol use
    Mild diseases only without substantive functional limitations. Examples include (but not limited to): current smoker, social alcohol drinker, pregnancy, obesity (30 < BMI < 40), well-controlled DM/HTN, mild lung disease.
  • ASA III
  • A patient with severe systemic disease
    Substantive functional limitations; One or more moderate to severe diseases. Examples include (but not limited to): poorly controlled DM or HTN, COPD, morbid obesity (BMI ≥40), active hepatitis, alcohol dependence or abuse, implanted pacemaker, moderate reduction of ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant PCA < 60 weeks, history (>3 months) of MI, CVA, TIA, or CAD/stents.
  • ASA IV
  • A patient with severe systemic disease that is a constant threat to life
    Examples include (but not limited to): recent ( <3 months) MI, CVA, TIA, or CAD/stents, ongoing cardiac ischaemia or severe valve dysfunction, severe reduction of ejection fraction, sepsis, DIC, ARD or ESRD not undergoing regularly scheduled dialysis.
  • ASA V
  • A moribund patient who is not expected to survive without the operation
    Examples include (but not limited to): ruptured abdominal/thoracic aneurysm, massive trauma, intracranial bleed with mass effect, ischaemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction.
  • ASA VI
  • A declared brain-dead patient whose organs are being removed for donor purposes
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About

The ASA classification changed on 15 October 2014.

It has become a lot more liberal and many people will go down a grade (i.e. be sicker).

It matters to 'code' patients correctly because otherwise we will look worse on national comparisons, and you may look worse compared to your colleagues. I believe it may also affect income with PBR.

I have corrected some of the spelling♥.

Ian Sidwell