Application Of ASA Physical Status Classification In Outpatient Department Of Oral＆Maxillofacial Surgery

With the development of society and the advance of medical therapy in themeidcal profession, the number of older persons seeking oral treatment, and thenumber of the patients with systemic disease or dental anxiety were increasingevery year. In addition, indications for dental treatment were expanding graduallyat the same time. All of these resulted in the growing of the Life-threateningemergencies. Life-threatening emergencies can happen to anyone-a patient, adoctor, a menber of the office staff, or even a person who is merelyaccompanying a patient.In this study, we used the ASA Physical Status Classification System(referred to as ASA classification or ASA status) which was designed by theAmerican Society of Anesthesiologists, to evaluate the patients who wasscheduled to receive “anesthesia” for a surgical procedure. However，there aresome limitations of the ASA classification when used in oral treatment. Therefore,we have supplemented and refined it. The purpose was to forecast the potentialrisks in the whole treatment, and to take further preventive and first-aid measures to reduce the occurrence of the Life-threatening emergencies.This study collected all patients’ medical information and Life-threateningemergencies in the Outpatient Department of Oral&Maxillofacial Surgery,School of Stomatology, FMMU, from April2003to March2012, and had takenepidemiological investigation and comparison analysis.The study was divided into two parts:PartⅠ:This part collected all the patients’ medical information for anepidemiological investigation, including age, gender, ASA classification andtreatment, from April2009to March2012.Results showed that:1. With the increasing number of the patients in the department year by year, thenumber of the patients in ASAⅡor ASAⅢ was also increasing significantly.2. There was a close relationship between increased age and higher ASAclassification, and no obvious relation was found between ASA classification andgender.3. The patients with higher ASA classification usually had more simple oraltreatment than the patients with lower ASA classification.PartⅡ:This part collected all patients’ medical information and the Life-threateningemergencies in the department from April2003to March2012. The kinds andincidence of the Life-threatening emergencies before and after the application ofASA classification, and adoption of relative preventive and first-aid measureswere compared.Results showed that:1. ASA classification can help to forecast patients’ potential risks in treatment procedure.2. The preoperative evaluation, and effectively preventive and first-aid measurescan help to reduce the kinds of the Life-threatening emergencies.3. The preoperative evaluation, and effectively preventive and first-aid measurescan help to decrease the incidence of all kinds of the Life-threateningemergencies.4. Patients who more than60years old were vulnerable to the Life-threateningemergencies.In short, ASA classification is an effectively preoperative evaluation, whichcan help medical staff to know patients’ Physical Status and predict the potentialrisk. However, there were some certain limitations in ASA classificatin. Therefore,we enriched it based on our clinical experience, and applied it into our clinicalwork. Finally, the Life-threatening emergencies in the department were reducedsignificantly.