ASA Physical Status

[checklist name="variable_1" value="ASA I: A normal healthy patient|ASA II: A patient with mild systemic disease|ASA III: A patient with severe systemic disease|ASA IV: A patient with severe systemic disease that is a constant threat to life|ASA V: A moribund patient who is not expected to survive without the operation|ASA VI: A declared brain-dead patient whose organs are being removed for donor purposes"]
[conditional field="variable_1" condition="(variable_1).is('ASA I: A normal healthy patient')"][comment memo_color="green" memo="ASA I: Healthy, non-smoking, no or minimal alcohol use."]
[/conditional][conditional field="variable_1" condition="(variable_1).is('ASA II: A patient with mild systemic disease')"][comment memo_color="lightgreen" memo="ASA II - Mild diseases only without substantive functional limitations. Current smoker, social alcohol drinker, pregnancy, obesity BMI between 30 and 40, well-controlled DM/HTN, mild lung disease."]
[/conditional][conditional field="variable_1" condition="(variable_1).is('ASA III: A patient with severe systemic disease')"][comment memo_color="yellow" memo="ASA III: Substantive functional limitations. One or more moderate to severe diseases. Poorly controlled DM or HTN, COPD, morbid obesity - BMI 40+, active hepatitis, alcohol dependence or abuse, implanted pacemaker, moderate reduction of ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant PCA less than 60 weeks.  Over 3 months ago with MI, CVA, TIA, CAD, stents."]
[/conditional][conditional field="variable_1" condition="(variable_1).is('ASA IV: A patient with severe systemic disease that is a constant threat to life')"][comment memo_color="orange"  memo="ASA IV: Less than 3 months ago with MI, CVA, TIA, CAD, stents.  Ongoing cardiac ischemia or severe valve dysfunction, severe reduction of ejection fraction, sepsis, DIC, ARDS, or ESRD not undergoing regularly scheduled dialysis."]
[/conditional][conditional field="variable_1" condition="(variable_1).is('ASA V: A moribund patient who is not expected to survive without the operation')"][comment memo_color="red" memo="ASA V: Ruptured abdominal/thoracic aneurysm, massive trauma, intracranial bleed with mass effect, ischemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction."][/conditional]

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 1, 11 form elements, 1 check lists, 5 comments, 5 conditionals, 6 total clicks
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