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Related Concept Videos

Physical Assessment of the Respiratory Tract II: Inspection01:27

Physical Assessment of the Respiratory Tract II: Inspection

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Physical assessment of the respiratory tract through inspection is a crucial step in understanding the patient's respiratory health. It provides insights into the functioning of the respiratory system, the musculoskeletal structure, and even the patient's nutritional status. This comprehensive approach involves observing several vital aspects: chest configuration, breathing patterns, respiratory rates, skin color, and use of accessory muscles.
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Data Collection III01:05

Data Collection III

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The physical assessment examines the patient for objective data that defines the patient's condition, and aids in formulating the nursing care plan. The purpose of physical assessment is a health status appraisal, which includes identifying health problems, and establishing a database for nursing intervention.
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the...
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A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
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Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
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Assessment of Respiration01:23

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The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
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Physical Assessment of the Respiratory Tract I: Health History01:28

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Physical assessment of the respiratory tract is critical to patient care. It allows healthcare professionals to identify and manage various respiratory conditions. The process involves a combination of subjective and objective data collection.
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Updated: Jan 13, 2026

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Reliability of the Pediatric-Specific American Society of Anesthesiologists Physical Status (ASA-PS) Classification

Lucy Liu1,2, Lucy Foote1, Evgenia Kolyvaki3

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Paediatric Anaesthesia
|January 8, 2026
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Summary
This summary is machine-generated.

Inter-rater reliability for the American Society of Anesthesiologists Physical Status (ASA-PS) classification in pediatric patients shows moderate agreement. Many pediatric patients are underscored, highlighting the need for improved ASA-PS scoring accuracy.

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Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Patient Safety

Background:

  • The American Society of Anesthesiologists Physical Status (ASA-PS) classification system is a standard for assessing patient comorbidities and perioperative risk.
  • Modifications have been made to the ASA-PS system since its 1941 inception, including pediatric-specific guidance in 2020.

Purpose of the Study:

  • To evaluate the inter-rater reliability of the ASA-PS classification system within the pediatric population.
  • To identify factors contributing to discrepancies in ASA-PS scoring among pediatric patients.

Main Methods:

  • A retrospective analysis of 364 pediatric patients at a quaternary hospital.
  • Three ASA-PS scores were assigned to each patient: one by the case anesthetist and two by independent consultant anesthetists.
  • Concordance was assessed using weighted kappa coefficients, with analysis of reasons for discordant scores.

Main Results:

  • Strong concordance was observed between the two independent consultant anesthetists (kappa = 0.76).
  • Moderate concordance was found between the case anesthetist and independent anesthetists (kappa = 0.5).
  • Discrepancies often involved the case anesthetist underscoring the ASA-PS score by one point, particularly in patients with complex conditions like symptomatic cardiac disease, abnormal BMI, oncologic states, brain malformations, or difficult airways.

Conclusions:

  • Moderate inter-rater variability exists in pediatric ASA-PS scoring, with a tendency for underscoring.
  • Utilizing the 2020 ASA guidance for pediatric cases enhances scoring reliability.
  • Improved ASA-PS scoring accuracy can lead to better communication of perioperative risks in children.