Anesthesia Working Group

Meeting Minutes

Telecon: December 13, 2017 13:00 ET

Contents

Attendees

Agenda Topics

1.Final review of neuraxial blocks (with reference to Andrew Marchant’s document)

2.Review of Airways (with reference to Ellen Torres’ document)

3.Next meeting date

Supporting Documents

Minutes/Conclusions Reached

Neuraxial Blocks

Airway Management

Next telecon

Wednesday December 13, 2017 13:00 ET

Attendees

Name / Abbrev. / Organization / Country / Email
Andrew Marchant / AM / NHS Lothian / UK /
Andrew Norton / AN / IHTSDO Anesthesia SIG / UK /
Ellen Torres / ET / Representing self / USA /
John Walsh / JW / MGH / USA /
Martin Hurrell / MH / Representing self / UK /
Terri Monk / TM / University of Nebraska Medical Center / USA /

Quorum met: Y

Agenda Topics

  1. Final review of neuraxial blocks (with reference to Andrew Marchant’s document)
  2. Review of Airways (with reference to Ellen Torres’ document)
  3. Next meeting date

Supporting Documents

Neuraxial Blocks – Andrew Marchant.docx (Author: Andrew Marchant)

Requirement for Airway Management.docx (Author: Ellen Torres)

Minutes/Conclusions Reached

Neuraxial Blocks

  • The document Neuraxial Blocks – Andrew Marchant.docx was reviewed and all elements were confirmed and are consistent with the provisional modelling in the DAM.
  • Test doses can be modelled in the same way as any other substance administration with the clinical intent as ‘test dose’.
  • AN commented that some terms identified by by AM, though useful, are unlikely to have equivalents in SNOMED CT and so will need to be recorded as free text e.g. ‘bony obstruction’
  • Review of all existing materials on this topic is now complete and no further discussion will be scheduled until the model for this topic is available.

Airway Management

  • The document Requirement for Airway Management.docx was reviewed
  • ET saidthat she had systematically noted requirements for various types of airway and identified repeating elements that apply across the board. Most categories could use afacilityfor free text notes.
  • It was agreed to model ‘oral’ and ‘nasal’ descriptions of airways as routes and allow users to infer whether or not to regard these descriptions as intrinsic attributes. In the same way, it was generally agreed that device metrics should stand in for explicit descriptions of devices such as ‘pediatric’ or ‘adult’ since there is considerable overlap and much depends on the context of use.
  • The issue of referencing a pre-existing airway not placed as part of the anesthetic procedure and without an existing ID was noted. MH suggested applying a unique ID in this case.
  • A requirement for ‘Patient Protection’ and ‘Positioning’ resources was noted. This point has been raised previously in other contexts.
  • AN said that, in SNOMED CT, concepts such as ‘difficult airway’ and ‘failed intubation’ would be classified as findings associated with the relevant procedure. The alternative classification ‘disorder’, is, in SNOMED CT synonymous with ‘disease’ and is therefore inappropriate
  • Bite blocks require elaboration of type. The use of bite blocks is an aspect of Patient Protection
  • AM noted the requirement to record multiple types of ventilation in the context of a single anesthetic procedure and also that laryngoscopes should be classed as invasive devices.

Next telecon

It was agreed that the next telecon would be scheduled for Thursday 4th. January, 2018 at 13:00 ET.