Attendees were welcomed by Andrew Norton and a brief summary of the growth of anaesthetic terminology was given, with specific reference to the work of the Anaesthesia CRG, formerly SIG, in SNOMED/ IHTSDO.

Monica Harry supports the CRG as a terminologist, and briefly introduced her role.

2018-03-27 Anesthesia CRG Call

The minutes of this meeting were reviewed and accepted as a suitable record.

Review of sections of SNOMED CT hierarchy:

• 128258000 Ventilation finding
• 250763003 Anesthetic finding
  
  

Include consideration of relevance of terms under anesthetic finding to other medical specialties

Discussion of terminology relating to Accidental Awareness under GA (AAGA, see the NAP5 audit) was used as an example of the group's work.  Terminology will develop to accommodate AAGA as a search term and definition.

A number of other terms are undergoing revision and have been submitted to the content request system.

The structure of Ventilation Finding and Anaesthetic Finding was considered; "grouper" terms such as "Anesthetic finding" should be removed where they do not add value.  Some groupers may be removed, some should be renamed.

Anesthetic finding

Potentially redundant terms for difficulty with airway management, inc. intubation, were reviewed. Monica Harry and teh the group will look at these with a view to the conseqeunces consequences should we amalgamate them all.  The group noted that the term "intubation" was previously used to primarily refer to "intubation of the trachea", but wider use is now normal (e.g. placing a gastroscope in the oesophagus).  We may have to modify "intubation" terms to explicitly specify "tracheal intubstion intubation".  Classification structure will stay the same at moment.

CICV was not found in the pending release of SNOMED, Monica Harry will review this and see if its inclusion can be expedited.

Distinction between "Anaesthesia Finding" and "Anesthetic Finding" was not clear - changes were not made.

"Ventilation finding" was reviewed.

Terms will be reviewed so that terms properly fit their concepts; so that a continuous measurement (e.g. minute volume, or minute volume) is an Observable EntitiyEntity, and the diagnosis of Hypoventilation will be a Finding.

SNOMED definition of Observable Entity
SNOMED definition of Finding

Minute volume and Minute ventilation are currently distinct concepts. Consider making them synonyms, with the primary term being an observable entity.

Multiple terms are noted which relate to terms such as Minute Volume; Andrew Norton will review these. 

Anaesthesia 2018; doi:10.1111/anae.14247. The Airway App: exploring the role of smartphone technology to capture emergency front-of-neck airway experiences internationally.

The article presents the following terms re cricothyroidotomy:

Scalpel–bougie Cricothyroidotomy
Open Cricothyroidotomy
Cannula Cricothyroidotomy
Wire-guided Cricothyroidotomy
(may develop to include use of adjunctive tools, e.g. surgical hook)

It also presents these for Tracheostomy:

Open tracheostomy
Percutaneous Tracheostomy

A number of previous terms have been retired, new terms modelled.

Review new model and parent concepts