The Board of Directors at its March meeting, asked that ASA members give their pertinent input to the Committee on Standards of Care regarding the issue of "Use of Audible Monitoring Alarms in the Operating Rooms."

APSF has recommended the following additions (noted below in red) to the "Standards for Basic Anesthetic Monitoring":

STANDARDS FOR BASIC ANESTHETIC MONITORING ( Approved by ASA House of Delegates on October 21, 1986 and last amended on October 27, 2004) STANDARD II OXYGENATION METHODS 2) Blood oxygenation: During all anesthetics, a quantitative method of assessing oxygenation such as pulse oximetry shall be employed.* When the pulse oximeter is utilized, the variable pitch pulse tone and the low threshold alarm must be audible .** Adequate illumination and exposure of the patient are necessary to assess color.* VENTILATION METHODS 2) When an endotracheal tube or laryngeal mask is inserted, its correct positioning must be verified by clinical assessment and by identification of carbon dioxide in the expired gas. Continual end-tidal carbon dioxide analysis, in use from the time of endotracheal tube/laryngeal mask placement, until extubation/removal or initiating transfer to a postoperative care location, shall be performed using a quantitative method such as capnography, capnometry or mass spectroscopy.* When capnography is utilized, the capnograph alarms must be audible .** **Under extenuating circumstances the responsible anesthesiologist may waive the requirements marked with an asterisk ( * ); it is recommended that when this is done, it should be so stated (including the reasons) in a note in the patient's medical record.

The Committee on Standards of Care will consider these additions at their May 1, 2005 meeting during the ASA Legislative Conference. It is their intent to present these recommendations for Board of Directors action at the August 2005 meeting.

Comments may be submitted to Marlene Larson at ASA headquarters.