Accuracy is essential when it comes to physical status modifiers in the anesthesiology field, and as of January 2016, the ASA Physical Status Classification System (modifiers P1-P6) includes examples to assist in choosing the appropriate modifier.
The original version was published in 1941 by Meyer Saklad, and then by ASA in a booklet for the members of its organization. In Saklad’s opinion, the pre-operative classification of a patient’s physical status was a very useful statistical tool, and he was adamant that “no attempt should be made to prognosticate the effect of a surgical procedure upon a patient of a given Physical State.”
In 1962, when the ASA published a revised version of Saklad’s system, it failed to include examples. Numerous studies have proven that clinicians’ assignments of PS modifiers are quite subjective and not prone to consistency, resulting in multiple PS classes assigned to the same patient.
A Wide Range of Uses
Now, the ASA PS Classification System is used for many purposes beyond the characterization of a patient’s physical status as it relates to anesthesiology. Things like paying for anesthesia services, allocating risk, and predicting perioperative risk are all included in those purposes. For this reason, the ASA chose to use the following examples in its system so that classifications become more uniform.
The more consistency we can have in physical status modifiers, the better, because everything from work assignments to finances are affected by them.
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