he ASA Board of Directors held its annual meeting in Chicago, Illinois, on Saturday and Sunday, August 20-21, 2005. The Board committees on Administrative Affairs, Finance, Legislative Review and Scientific Affairs held open hearings on Saturday to review reports for consideration by the Board of Directors on Sunday. Among the actions taken by the Board of Directors were the following:

Standards and Practice Parameters
Subject to House of Delegates ratification, approved a recommendation to merge the activities of the Committee on Standards of Care into the ongoing work of the Committee on Practice Parameters, thus creating a new Committee on Standards and Practice Parameters.

Also subject to House of Delegates ratification, approved an amendment to the ASA Standards for Basic Anesthetic Monitoring regarding monitoring of the patient’s oxygenation and ventilation, to include the following added language:

• Standard II, Blood oxygenation: “When the pulse oximeter is utilized, the variable pitch pulse tone and the low threshold alarm shall be audible.”

• Standard II, Ventilation: “When capnography or capnometry is utilized, the alarms shall be audible.”

Received, for review and comment, four new or updated practice parameters that will be submitted to the House of Delegates in October for approval:

1. Practice Guidelines for Perioperative Management of Patients With Obstructive Sleep Apnea (new). This task force is chaired by Jeffrey B. Gross, M.D.

2. Practice Advisory for Perioperative Visual Loss Associated With Spine Surgery (new). This task force is chaired by Mark A. Warner, M.D.

3. Practice Advisory for Intraoperative Awareness and Brain Function Monitoring (new). This task force is chaired by Jeffrey L. Apfelbaum, M.D.

4. Practice Guidelines for Blood Transfusion and Adjuvant Therapies (updated). This task force is chaired by Gregory A. Nuttall, M.D

Also received information that practice parameters currently being developed or updated are: practice guidelines for prevention of operating room fires; obstetrical anesthesia; neuraxial anesthesia; preoperative fasting; cancer pain and chronic pain management; and transesophageal echocardiography.

American Association of Nurse Anesthetists (AANA)
Subject to House of Delegates ratification, disapproved a recommendation to adopt a Joint Statement on Anesthesia Practice prepared with leaders of the American Association of Nurse Anesthetists as a means to recognize the evolving roles of anesthesia professionals and to ensure the involvement of anesthesia professionals in the delivery of anesthesia care.

Also subject to House of Delegates ratification, disapproved a resolution that recommended withdrawal from mediated meetings with the AANA leadership. Testimony indicated that dialogue with AANA should continue at the discretion of the Executive Committee.

Also subject to House of Delegates ratification, disapproved a recommendation that ASA Educational Membership no longer be offered to certified registered nurse anesthetists.

Provision of Anesthesia Care by Nonanesthesiologists
Referred a report from the Committee on Patient Safety and Risk Management to the Administrative Council for possible involvement of the ASA leadership in addressing issues related to the provision of anesthesia care by physicians who are not in the specialty of anesthesiology.

Subject to House of Delegates ratification, referred to a committee of the President’s choice for further study, the proposed statement “Credentialing Guidelines for Practitioners Who Are Not Anesthesia Professionals to Administer Anesthetic Drugs to Establish a Level of Moderate or Deep Sedation.”

2006 Relative Value Guide
Approved a recommendation by the Committee on Economics to insert the following text into the 2006 Relative Value Guide relating to obstetrical anesthesia (new language underscored):

• “Professional charges and payment policies should reasonably reflect the costs of providing labor analgesia as well as the intensity and time involved in performing and monitoring any neuraxial labor analgesic.

• Basic units, plus patient contact time (insertion, management of adverse events, delivery, removal) plus one unit per hour for neuraxial analgesia management plus direct patient contact time (insertion, management of adverse event, delivery, removal).”

Educational Mission Statement
Subject to House of Delegates ratification, approved recommended revisions to ASA’s “Educational Mission Statement” as submitted by the Committee on Professional Education Oversight.

Organ Donation After Cardiac Death
Subject to House of Delegates ratification, approved a recommendation that protocols for individual hospitals should be developed with the assistance of guidelines developed by the Institute of Medicine and the United Network for Organ Sharing for the provision of ethical terminal care for organ donor patients and their families. The Board indicated that the Committee on Transplant Anesthesia, with further input from the Committee on Ethics, should educate ASA members and assist them in developing such guidelines and protocols.

Anesthesia Care Team Statement
Subject to House of Delegates ratification, referred a proposed revision of the Anesthesia Care Team Statement, last amended by the House of Delegates in October 2001.

Trauma and Emergency Preparedness
Subject to House of Delegates ratification, approved a recommendation to establish the current ad hoc committee as a standing Committee on Trauma and Emergency Preparedness.

Performance and Outcomes Measurement
Subject to House of Delegates ratification, approved revisions to the “Guiding Principles for Database Management of Performance Measures” as recommended by the Committee on Performance and Outcomes Measurement (CPOM), which describes guidelines for data management (technical standards and organizational oversight) that will allow ASA to pool performance measurement data into a comprehensive relational database.

Honoraria and Awards
In order to achieve consistency with the new ASA travel and reimbursement policy, approved the recommendations from the Committee on Honoraria and Awards for adjustments to honoraria and awards relating to the Annual Meeting. Approval of these recommendations is subject to ratification by the House of Delegates.

2006 Budget and Dues
Approved a 2006 budget to provide total income of $23,824,925. The 2006 expense budget of $24,264,390 was approved and will be forwarded to the House of Delegates for adoption. The 2006 budget includes funding for the Anesthesia Patient Safety Foundation (APSF), the Foundation for Anesthesia Education and Research (FAER) and the Wood Library-Museum of Anesthesiology (WLM) as follows:

APSF - $500,000

FAER - $1,500,000

WLM - $400,000

Recommended that the House of Delegates approve the following 2006 membership dues, which are unchanged from 2005:

Active Members - $450

Affiliate Members - $225

Educational Members - $225

Resident Members - $25

Educational Student Members - $25

Medical Student Members - $10

Member Insurance Benefits
Subject to House of Delegates ratification, recommended that ASA further explore options to offer health insurance and other member benefits to the ASA membership with advice from legal counsel.

Anesthesia Foundation
Subject to House of Delegates ratification, approved a recommendation that the Anesthesia Foundation, in its attempt to strengthen ties with ASA, be recognized by the ASA in the same fashion as the Foundation for Anesthesia Education and Research, the Anesthesia Patient Safety Foundation and the Wood Library-Museum of Anesthesiology. It was noted that there would be no fiscal impact to ASA as a result of this new recognition of the Anesthesia Foundation.