1. Anne Casey Chair, IHTSDO Nursing SIG

2. Issues Synonymous terms? Whether or not synonymous : inconsistent application – mainly in procedures but also in observables and findings. Issue discussion led by Anaesthesia SIG - see Issue document c00140 last dated October 2009.

3. Anaesthesia SIG view Supported by Nursing SIG (except UK) Any term related to catheter, cannula or line should be considered for appropriate synonym terms for each of these concepts. SNOMED CT already implicitly recognizes this, (see example below) but it is not implemented in a consistent and systematic way. Examples: catheterization of vein 392230005. includes synonym terms that include the term ‘line’ but not ‘cannula’ Immediate descendant, central venous cannula insertion 233527006 includes ‘cannula’ and ‘line,’ although its parent term is a catheterization

4. Proposals The anesthesia SIG considers that vascular access terms including, catheter, cannula, line, catheterization, cannulation should be populated with synonyms for each of the three terms. In device (physical object) there are a number of examples where the concept catheter, cannula and line have been treated as separate and distinguishable concepts: e.g. arterial cannula, arterial line, arterial catheter. It is proposed that these should be aggregated into a preferred concept with synonyms and the redundant terms retired.

5. UK nursing view (UK practice guidelines as primary reference) Catheter, cannula, line are not always synonymous. Procedures and competence level for insertion, maintenance and removal are different. In nursing records, in situ devices are commonly referred to as peripheral cannula central venous catheter or central line arterial line The terms ‘peripheral intravenous catheter’ and ‘central venous cannula’ are used by UK nurses.

6. Suggested next steps Add issue of inconsistency to Content Committee Tracker Attach historical documentation to tracker Attach Pharmacy SIG view (if agreed) to tracker Rationale: formal content development process with involvement of all stakeholders before any proposals can be actioned.

8. The Medical Devices view Catheter and cannula represent different devices e.g., a “Tracheal cannula” could never be named as a “Tracheal catheter”, and visa-versa an “Angiographic catheter” could never be named as an “Angiographic cannula” Decision on terming is dependent on the device supporting Information for Users (IFU), brochure/sales material, and User Manuals

9. GMDN statement “…..you cannot make the simple conclusion that “Catheter” and “Cannula” mean the same thing – this is conclusively wrong…..”