ASA Physical Status Classification System Quiz

ASA Physical Status Classification System

• Evaluates medical risk associated with patients.
• Categorizes patients into five levels (ASA I to ASA V), with "E" prefix indicating emergency situations (e.g., ASA E-III).

Categories of ASA Classification

• ASA I: Normal, healthy patients without systemic disease; capable of normal activities without distress.
• ASA II: Patients with mild systemic disease or extreme dental fear; minimal risk, treatment modifications may be needed.
• ASA III: Patients with severe systemic disease limiting activities; may exhibit distress under stress, modified treatment required.
• ASA IV: Patients with incapacitating systemic disease; distress at rest, elective dental treatment not indicated.
• ASA V: Patients not expected to survive 24 hours; terminally ill, emergency dental treatment only for palliation.

Relative Value System

• The classification is flexible and considers the significance of multiple diseases affecting the patient.

ASA I Details

• No systemic diseases; good health of heart, lungs, liver, kidneys, CNS.
• No treatment modifications needed; capable of walking a flight of stairs without distress.

ASA II Details

• Patients with mild systemic diseases such as well-controlled diabetes, asthma, or severe dental anxiety.
• Generally capable of normal activities, with caution for treatment.

Examples of ASA II Patients

• Well-controlled diabetes (HbA1c ≤ 7%).
• Patients with severe allergies, healthy pregnant women, and others with mild systemic issues.

ASA III Details

• Severe systemic disease; distress occurs under physical/psychological stress.
• Treatment modifications needed; may need to stop during physical activities.

Examples of ASA III Patients

• Conditions like stable angina, post-MI, moderately controlled diabetes, and COPD.

ASA IV Details

• Life-threatening conditions causing distress at rest.
• Elective dental treatments not indicated; non-invasive management preferred.

Examples of ASA IV Patients

• Unstable angina, advanced cirrhosis, severe congestive heart failure.

ASA V Details

• Patients with terminal conditions not expected to survive 24 hours.
• Elective dental treatment is contraindicated; only palliative emergency care is considered.

Examples of ASA V Patients

• End stage renal disease, terminal cancer, end stage infectious diseases.

Candidates for Treatments

• ASA I, II, and III patients are candidates for elective and emergency treatments.

Diabetes Classification

• Well-controlled diabetes corresponds to ASA II; fair control to ASA III; poorly controlled to ASA IV.

Cerebrovascular Disease Classification

• ASA II for CVA/TIA over 12 months ago with mild effects.
• ASA III for one CVA with moderate-severe effects or within 6-12 months.
• ASA IV for recent or multiple CVAs.

Renal Disease Classification

• ASA III for dialysis or stable transplantation; ASA IV for transplant rejection or chronic renal failure.

Myocardial Infarction Classification

• ASA III for stable post-MI over 30 days; ASA IV for unstable conditions; ASA V for acute MI within one week.

Hypertension Classification

• ASA II for controlled primary hypertension; ASA III for controlled secondary hypertension; ASA IV for uncontrolled hypertension.

Congestive Heart Failure Classification

• ASA II for class 1; ASA III for class 2 or 3; ASA V for class 5.

Arrhythmia Classification

• ASA II for low-risk arrythmias; ASA III for moderate risk; ASA IV for high risk.

Angina Pectoris Classification

• ASA II for class 2; ASA III for class 3 (vasospastic); ASA IV for class 4 (unstable angina).