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According to one of the references an 257227000|Anesthetic laryngoscope (physical object)| is a duplicate of 706013009 |Intubation laryngoscope (physical object)|. I'm in doubt if it is a real duplicate or if a anesthetic laryngoscope is a kind of intubation laryngoscope. In that case the anesthetic laryngoscope should be a descendant of the intubation laryngoscope.
I have received the concepts as requests for addition to the international release. Please see the google sheet including references provided. I am asking for the use case and definitions. Would appreciate your opinion on the use case for any of these and if any are ambiguous either or grouper concepts. Here is the link: https://docs.google.com/spreadsheets/d/1ZaCnclakLYTl3Qr3yScqXG7_lzu905sUl5HrrKVJUcw/edit?usp=sharing
The group that is attempting to build a FHIR IG for Anesthesia records has begun working on the Epidural use case. Several SNOMED codes have been included but there doesn't seem to be a code for "identification of the epidural space". There are codes for levels, structures and insertion of a catheter. There are also codes for the loss of resistance techniques (air, saline and hanging drop). Is there an appetite for a concept of "identification of a target structure" that could then be speci
Discussion of adding SNOMED codes for other common iv solutions
There are terms for the intervertebral foramina, however, the intervertebral foramen is the opening between every two vertebrae where the nerve roots exit the spine, so that is not correct for epidurals. It is good for foraminal blocks Currently there is Structure of intervertebral space (body structure) SCTID: 47886009 and image-2024-3-11_11-45-9.png Not really sure what these refer to? Is this referring to the space between the vertebral bodies where the disc lies? It doesn't say betwe
Discussion about the usefulness and meaning of the term 1263452006 |Anesthesia and/or sedation procedure (procedure)|
We have received a CRS request to inactivate one or other of the above referenced concepts. Suggest a review of the hierarchy under 274497003 |Nerve injection (procedure)| is required.
Discussion on how to represent hyperbaric bupivacaine in SNOMED
As promised at the 2022-03-22 meeting. Please see document in Documentation folder
This area of the hierarchy is under review in an effort to distinguish between procedures i.e. one time occurrence vs multiple occurrences over time whether continuous or intermittent. Please review the xls here: https://docs.google.com/spreadsheets/d/1u9WAEIoqvzn0_dmrSTvgW8QI6W0D_O9cp452TkMwayI/edit?usp=sharing https://docs.google.com/spreadsheets/d/1u9WAEIoqvzn0_dmrSTvgW8QI6W0D_O9cp452TkMwayI/edit?usp=sharing and add your comments to the appropriate column or add a column. We hope to discuss
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Discussion | Laryngoscope | In discussion | 0 | View 76 | Comment 2 | 1738949602000 Feb 7, 2025 17:33 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Feb 9, 2025 00:25 | 2 | Undefined | |
Question | Request for new ventilation regime/therapy concepts | New | 0 | View 65 | Comment 0 | 1736197265000 Jan 6, 2025 21:01 | 0 - | 0 - | Undefined | |
Discussion | Concept for the Identification of a Target Structure and Device Placement | In discussion | 0 | View 493 | Comment 1 | 1716288317000 May 21, 2024 10:45 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) May 28, 2024 20:01 | 1 | Undefined | |
Discussion | IV Fluids | In discussion | 0 | View 809 | Comment 2 | 1712088799000 Apr 2, 2024 20:13 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) May 8, 2024 16:34 | 2 | Undefined | |
Discussion | Epidural and Spinal levels | In discussion | 0 | View 29 | Comment 3 | 1710171790000 Mar 11, 2024 15:43 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Mar 26, 2024 18:47 | 3 | Undefined | |
Discussion | 1263452006 |Anesthesia and/or sedation procedure (procedure)| | In discussion | 0 | View 662 | Comment 3 | 1699471846000 Nov 8, 2023 19:30 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Apr 16, 2024 13:27 | 3 | Undefined | |
Discussion | Nerve block vs Local anesthetic nerve block (procedure) | In discussion | 0 | View 477 | Comment 1 | 1682437306000 Apr 25, 2023 15:41 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Apr 26, 2023 15:22 | 1 | Undefined | |
Discussion | Baricity of Local Anesthetics | In discussion | 0 | View 1633 | Comment 3 | 1649171763000 Apr 5, 2022 15:16 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Apr 6, 2022 16:32 | 3 | Undefined | |
Discussion | Terms that puzzle me | New | 0 | View 1008 | Comment 0 | 1648067385000 Mar 23, 2022 20:29 | 0 - | 0 - | Undefined | |
Discussion | 266700009 |Assisted breathing (procedure)| | In discussion | 0 | View 520 | Comment 1 | 1648057012000 Mar 23, 2022 17:36 | $date.format('yyMMddHHmm', $lastComment.getCreationDate()) Apr 6, 2022 08:32 | 1 | Undefined |
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5 Comments
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We have received an enquiry regarding these two concepts as to whether they are duplicate. Would you please consider and advise on the following:
287439000|Emergency tracheostomy (procedure)|
55622001|Tracheostomy, emergency procedure by transtracheal approach (procedure)|All comments appreciated. Thank you for your attention to this matter. Monica
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Hello Monica,
55622001 is the same as 287439000 in an emergency setting. Does this help?
J
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Yes but I think we may need to make this an agenda item for discussion:
I have looked into this a bit further and the issue is that both concepts are defined using the same attributes and values so the reasoner classifies them similarly i.e. as:
Exteriorization of the trachea via transtracheal approach
- Is this considered a bypass as one concept is modelled as such
- Is it correct to make this a subtype of 75506009 |Construction of stoma (procedure)|
- Is there an approach other than Transtracheal
- Then we have as well: 307007002 |Percutaneous tracheostomy (procedure)|
If transtreacheal is the approach for all, how are they different?Note: Steven has sent me an article in an email which I will review separately.
thanks, Monica
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Monica, James, Steven
Agree it would be useful to discuss this area at the next Anesthesia CRG meeting - it is scheduled for Tuesday 26th November.
As in the review article that Steven kindly provided, there are basically two fundamental techniques of performing a tracheostomy: open surgical and percutaneous, of which there are a number of variants of each. I suppose (perhaps incorrectly) I have presumed the "transtracheal" to reference primarily open tracheostomy, although I suppose thinking about it more logically, the approach for both principle techniques could be regarded as transtracheal.
Think that we may have also have to give some thought to 307007002 |Percutaneous tracheostomy (procedure)|
As currently classified the approach attribute is "percutaneous approach" which seems fine, and the method attribute is "bypass - action", but this does result in the parents of the concept being 48537004 Bypass graft (procedure) and 367439007 Repair of trachea (procedure), the latter does have tracheostomy terms as descendants, but one would probably also want to classify percutaneous tracheostomy as an exteriorization of trachea like the other surgical tracheostomy terms.
Best wishes
Andrew
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On the face of it not, since one includes the transtracheal approach. I can see where Andrew Norton is going with bypass - action but it appears there is implicit vascular bypass if it is being subsumed by bypass graft. I would expect to see them related as below; however whether Emergency tracheostomy is enough to be clinically useful I will ask anaesthetic colleagues to comment. https://www.headandnecktrauma.org/wp-content/uploads/2016/09/Tracheostomy-Technique-Approach-Considerations.pdf
287439000|Emergency tracheostomy (procedure)|
55622001|Tracheostomy, emergency procedure by transtracheal approach (procedure)|
Apart from a number of potential additional concepts, I am not convinced a number of the descriptions meet the requirements for an FSN even if OK for preferred terms. Much of the technique and approach can be implicit in the term and therefore not sufficiently helpful for modelling. There may well be a number of approaches missing, not just in this area but particularly when one considers the less surgical healthcare activities.
Andrew Marchant