Volume 7, No. 4 • Winter 1992

ASA Slightly Modifies Standards

Small but important modifications to two of the formal sets of ASA standards of practice were made by the House of Delegates at the October ASA Annual Meeting.

The Standards for Basic Intraoperative Monitoring were strengthened by the addition of the word ‘strongly’ to the encouragement of the use of continuous capnography. Item 2 of Standard 11, Ventilation, now reads: “When an endotracheal tube is inserted, its correct positioning in the trachea must be verified by clinical assessment and by identification of carbon dioxide in the expired gas. End-tidal C02 analysis, in use from the time of endotracheal tube placement, is strongly encouraged.”

Likewise, the Standards for Postanesthesia Care were supplemented by a new reference to the monitoring of temperature in the immediate postoperative period. The relevant section now reads: “…particular attention should be given to monitoring oxygenation, ventilation, circulation and temperature.”

Both changes were recommended by the ASA Committee on Standards of Care and were adopted by the House without opposition. In response to the directive from the 1991 House of Delegates, the Committee did evaluate the suggestion that continuous capnography be made a formal standard. The Committee felt that to do so would require a number of caveats and exceptions, particularly regarding pediatric patients, and that this, coupled with the features already in the existing standard as quoted above, argued in favor of not adopting the suggestion.