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Conference Call Details

Meeting time is 2019-05-28 20:00 UK; 15:00 US ET

Meeting ID: 374-360-670

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Discussion items

ItemTimeDescriptionOwnerNotes
1
Introductions and apologies

Apologies received from Zac Whitewood-Moores

2
Minutes of previous meeting

Review minutes from 2019-04-10 Anesthesia CRG Face-to-Face Meeting (London)

Agreed to be a correct record

3
Matters arising from the minutes

A number of items carried forward to this agenda

Work continues on standards for electronic anaesthesia records and, engagement with professional bodies in adopting such standards in accreditation, It is proposed to develop a draft standard for anesthesia records in the UK aligned to the format of Professional Records Standards Body standards. This work will be informed by the HL7 Domain Analysis model for Anaesthesia Records. Feedback awaited from report to AAGBI council

Coma, unconsciousness and concussion. Felt that a true consensus document for definitions is not achievable - A brief report of what the Anesthesia CRG views as best definitions available outlining preferred approach to assessment using Glasgow Coma score and other methods.

4
SNOMED CT terminology requests

Include recent correspondence on CRS request 740106 Mechanical Insufflation - Exsufflation. Marked completed. Question was whether a preexisting concept encompassed this concept, resolution was that a new concept was needed.

5
SNOMED updatesMonica Harry

Item not reached

6
Preservative free morphine for neuraxial blocks

CRS request 722226 refers

PF morphine has limited scope, not available in several countries. Suggest that national extensions implement this concept as necessary.

For reference, NHS DM+D shows medications in UK: https://apps.nhsbsa.nhs.uk/DMDBrowser/DMDBrowser.do

RxNav shows RxNorm listings (US):

https://rxnav.nlm.nih.gov/

7
Representation of IV fluids in revised product hierarchy

List of commonly used products in anesthesia (see attached Excel file IV Fluids.xlsx.)

SNOMED International is currently undertaking remodelling of products including IV fluids based on a model defining ingredients measured in metric units. This creates a partially automatically generated hierarchy of fully and sufficiently defined concepts. Work is currently in progress but anticipated that should be complete for the January 2020 release. Levels of detail that include pack sizes, manufacturers etc are deemed to be appropriate for national extensions.

Noted that the units adopted differ from current conventions, but the current view is that the International release should not be complicated by synonyms to accomodate different units or representations of composition.

Identified missing solutions were discussed and agreed that requests would be submitted before the close of the submission window (beginning October 2019) for the January 2020 release.

Noted that the representation of balanced electrolyte solutions would be difficult using the current SNOMED model.

Examples of anesthesia and ITU prescribing practice would provide use cases that inform the validation of and any amendments suggested to the current modelling approach.

8
ISO 19223 Ventilation Standard

Update on the ISO 19223 ventilation standard, now at the proofing stage. Norman Jones and Martin Hurrell discussed the meanings of patterns and inflation types defining modes as related to commonly used artificial ventilation in anaesthesia as tabulated by John Walsh

ventilation modes.xlsx

9
High flow (nasal) oxygen therapy

Commonly used method of oxygen delivery in high dependency care - characteristics of the method is that delivered oxygen is heated and humidified

However, the method is not just nasal - manufacturers (for example Fisher-Paykel) include adapters for delivering the same gas delivery to a tracheostomy. Consider requesting two concepts for the two delivery routes.

Norman Jones noted there will be an addendum to ISO 19223 that will cover this type of respiratory therapy

10
Any other business





11
Next meeting

Tuesday, July 23, 2019

File Size Creator Created Comment

Coding Briefing paper outline Vers1.docx

132732

Patrick McCormick

2019-May-19, 14:16  

IV Fluids.xlsx

11673

Andrew Norton

2019-May-25, 10:43  

ventilation modes.xlsx

12995

Andrew Norton

2019-Jun-03, 20:59  

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