Introduction to AMA style for Nurse Anesthesia

The Nurse Anesthesia Program at Saint Mary's University Twin Cities uses the American Medical Association Manual of Style (10th ed.). Students are required to purchase and learn to use the manual. The information below provides an introduction to the manual and other research resources.


Click on the image to open the booklet developed by the Twin Cities Writing Center to assist nurse anesthesia students with the American Medical Association Manual of Style.

Note: Always check with your instructor or advisor for required departures from AMA guidelines.



Q: Is it ok to use an abbreviations in headings? A: Abbreviations should not be used in headings (AMA 2.8.3), and should be used only sparingly elsewhere in the text. Read the cautionary guidelines at the top of AMA p. 442.

Q: Are there any restrictions on the use of abbreviations? A: Yes! Aside from the prohibition in headings, and aside from the necessity of introducing abbreviations, the AMA limits abbreviations to "approved" ones. Many of these appear in chapter 14 of the AMA manual. Others may be specified by journals to which manuscripts are submitted. In any case, abbreviations should be used sparingly. They are used for the convience of the writer, not the reader. Read pp. 441-442 and section 14.11 of the AMA manual.


Q: When do I capitalize words used as designators? A: Unless they are part of a title or heading, do not capitalize the following in your text: chapter, column, day, edition, factor, group,, level, month, page, paragraph, phase, section, stage, step type, volume, week [exceptions are Step I diet, Schedule II drug, and Axis I of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)]. Do capitalize Table and Figure (with or withour numerals) when used as designators within a specific article. See AMA 10.4.

Q: What words are capitalized in titles on the reference page? See AMA manual, section 3.9.1 and section 3.10.


Q: Is there a space after "doi:" on the reference page? A: There is no space after the colon that follows “doi” (see, for example, AMA #5, p. 65). Please note that the Saint Mary's CRNA program does not use DOI numbers.

Q: What is the correct capitalization of DOI and PMID? A: When mentioned in running text, the terms DOI and PMID usually appear in all caps. However, in a reference entry, doi is not capitalized but PMID is. The AMA provides no example of PMID in a reference (but see AMA 3.15); however an example is provided by McWhorter School of Pharmacy. Please note that the Saint Mary's CRNA program does not use DOI numbers.


Q: Do I use numbers or letters to label items listed within a paragraph? A: To enumerate within a paragraph use arabic numerals enclosed in parentheses (AMA p. 356), as in the following example:

Data were gathered by the following methods: (1) patient questionnaire, (2) observation reports by attending nurses, (3) Ramsey sedation scale assessment, and (4) heart rate variability as measured by the Polar S810i.

Half spaces

Q: How do I create half spaces for grouping of long numbers? A: Sections 18.4.3 of the AMA manual says to use a "thin space" rather than commas to group intergers of more than 4 digits into groups of 3. A "thin space" is defined by SI as 1/5 em space. The directions below describe how to insert a thin space between numbers.

1. Type the number. Then place the cursor where you want a space.
2. Hold down the Alt key and type 8201 on the number pad (not the keyboard). Release Alt.

Note that regular spacing can break up integers at the end of a line.  The thin space, however, is a non-breaking space, so grouped integers hold together regardless of where they fall on the page.


Q: When do I italicize words in the text? A: Find guidelines for use of italics in section 22.5.4 of the AMA manual. Do remember to use italics to introduce or define terms.
Example 1. "The following search terms were employed: head position, endotracheal, atlanto-occipital, and axes."
Example 2. "Central tendency refers to the way data are distributed."


Q: Just what are the AMA rules concerning the use of hyphens? A: The rules are numerous and complicated. The best information on hyphenating words is in section 18.3.1 of the manual. To find information about other hyphen uses, use the index to the manual and locate detailed entries under "hyphen."

Likert-type scale

Q: How do I describe a Likert-type scale in my text? A: We found no guidelines in the AMA for typing Likert-type scales in the text. However, p. 877 of the AMA manual (10th) offers a definition of Likert scale and formats the example this way:

1, strongly approve; 2, approve; 3, undecided or neutral; 4, disapprove; 5, strongly disapprove

Be consistent throughout your paper.

Numbers (See section 19 of AMA manual)

Q: When do I spell out "one"? A: When it (1) begins a sentence; (2) is used as a pronoun, as in one's home is a castle; (3) when it can be replaced by a, an, or the--in other words, when it does not express a specific quantity. See AMA 19.2.3 and 19.2.4.

Q: Which is correct: Five percent or 5 percent? If the percent begins the sentence, you would need to spell it out (five percent). However, "5 percent" is always wrong because you should use symbols with symbols (including numeric symbols) and words with words: five percent or 5%. See AMA 19.7.2.

Q: Q: How do I create half spaces for grouping of long numbers? A: Look under "Half Spaces" above.


Q: I want to start my paper with a quote. How do I cite and format? A: You are probably referring to an epigraph. See AMA section 2.7 (10th ed.)

Q: May I change the capitalization of the first word in a quote to make it fit my sentence? A: Yes, but place brackets around the letter (AMA 8.6.1).


Q: How do I format my references so they appear "blocked"? A: Click here for directions


Q: Is there a quick way to create superscripts in my paper? A: Click here for directions.

Q: How can I prevent a superscript from looking like an exponent when the superscript follows a number? A: Rearrange the passage so that the number and superscript do not follow one another. See AMA 19.3.2 for an example.

Trademark symbol

Q: Should I include a trademark symbol when I use a proprietary name (brand name) in my paper? A: Trademark symbols ( ® or TM) are not used in AMA text (AMA 15.4.) Trade names are rarely used in AMA writing. See AMA p. 357 and sections 15.4.3 and 15.5.

Versus or vs?

Q: Should I abbreviate the word versus, and if so, how? A: According to the AMA Style Insider blog [], the AMA prefers the abbreviation "vs" (no period, no capital) to spelling out the word.