credit hours annually4. Please see link below for the most recent Task Force recommendations from November 2014. Also, the ACS is not planning on offering verification in this program to independent free standing ambulatory surgical centers at this time, only those integrated into a health system.
This survey and verification process is still undergoing continuous revisions. There are plans for a few site visits in the spring to see how these potential criteria would work. Both the ACS and ASA are committed to work together to help delineate optimal resources standards for infants and children requiring surgical care. Stay tuned as more develops.
As of November 2014 the proposed classification based on level of resources for children’s surgical centers was as follows:
| LEVEL 1 COMPREHENSIVE CHILDREN’S SURGICAL CENTERS |
Complex and non-complex surgical procedures Children of all ages, including those with the most severe health conditions. ASA 1-5 |
Staffed 24/7 with pediatric specialists including pediatric and subspecialty surgeons, pediatric diagnostic and interventional radiologists, and pediatric emergency physicians. Two ABA or equivalent pediatric anesthesiologists on medical staff , with a response time of 60 minutes 24/7 On site pediatric anesthesia services must be immediately available 24/7 |
Level IV NICU |
|
| LEVEL 2 ADVANCED CHILDREN’S SURGICAL CENTERS |
Resources to provide surgical care for children of all ages including those with moderate comorbid conditions. ASA 1-3 |
Personnel include certified pediatric surgeon, pediatric radiologist, and other pediatric specialists readily available for consultation. Intensive care unit has pediatric expertise. One or more pediatric anesthesiologists must be on medical staff and must be available 24/7 within 60 minutes to serve as the primary anesthesiologist for children 5 years of age or less |
Level III or higher NICU |
|
| LEVEL 3 BASIC CHILDREN’S SURGICAL CENTERS |
Common, low-risk surgical procedures in children older than 6 months who are otherwise healthy ASA 1-2 |
It has general surgeons, anesthesiologists, radiologists, and emergency physicians with pediatric expertise | Level I NICU or higher |
Indications for transfer to Level I or II Centers: • < 60 weeks post menstrual age • Patient less than 6 months of age • High level of acuity, need for ICU |
REFERENCES
1. ACS press release March 3, 2014
2. Task Force for Children’s Surgical Care. Optimal resources for children’s surgical care in the United States. J Am Coll Surg 2014; 218:479-487.
3. Fitch J, Singleton M. Letter to the editor: American Society of Anesthesiologists on children’s surgical care. J Am Coll Surg 2014; 219:326-327.
