Purpose: To classify a patient undergoing anesthesia for the severity of clinical disease.       Citations with documentation. 31.01.01 Sriram & Svirbely 1997
     
data enter      
patient's age in years years      
:-):-):-) :-):-):-)      
Is the patient healthy, without any complaints? (Y or N) :-):-):-)      
number of body systems affected by disease      
number of major health problems      
number of serious health problems poorly controlled, uncontrolled or end-stage      
number of minor health problems      
         
enter only one 'x' for each row, under the appropriate column    
  none mild moderate incapacitated    
clinical impression of activity limitation Yes 2
  unlikely low possible very likely    
clinical impression of likelihood of death Yes 2
 
evaluate results  
data complete? Yes :-):-):-)  
c/w ASA Class I? No :-):-):-)  
c/w ASA Class II? No  
c/w ASA Class III? Yes  
c/w ASA Class IV? No  
c/w ASA Class V? No  
 

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