SCOPE OF PRACTICE 24/7 emergency surgical care Function Diagnosis and treatment of common surgical diseases Referral to next of care Age of patients All ages Physician or non-physician provider with pediatric exposure. Anesthesia General anesthesia for all pediatric surgical procedures not requiring invasive monitoring or ventilation. Trauma/injuries Resuscitation with advanced life support measures Wound closure Intercostal drainage tube (thoracostomy) Trauma Laparotomy Closed fracture: reduction, traction Open fracture: irrigation, debridement, placement of external fixator Trauma-related amputation Escharotomy, fasciotomy 1st, 2nd degree, skin grafting, simple contractures Burr hole/craniotomy Congenital General pediatric surgery: anomalies Neonatal intestinal obstruction: laparotomy Anorectal malformation: colostomy, anoplasty Hirschsprung’s disease: colostomy Hernia/hydrocele repair: inguinal, umbilical Pediatric urology/gynecology: Relief of urinary obstruction: catherization, suprapubic cystostomy, Male circumcision: neonate, older child, phimosis, paraphimosis Examples of Meatal stenosis types of Orchidopexy: testicular torsion, palpable undescended testes conditions/ Labial adhesion/agglutination procedures Hydrocolpos/hydrometrocolpos: imperforate hymen, low vaginal septum Pediatric orthopedics: Club foot: non-operative manipulation Infections Infections Thoracic empyema: thoracostomy Appendectomy Laparotomy: typhoid complications, intra-abdominal abscess Drainage of abscess: superficial, pyomyositis, perianal, anorectal Septic arthritis: drainage Osteomyelitis: drainage, débridement Dental surgery: extraction, drainage of abscess, caries Tumors Tumors Biopsy Excision of benign tumors/cysts Others Others Central venous line Intestinal obstruction: intussusception, enteroclysis Foreign bodies: ear, nose, throat, swallowed (Table 5 continued on next page)
SCOPE OF PRACTICE Function 24/7 emergency surgical care Diagnosis and treatment of common surgical diseases Referral to next of care Age of patients All ages Anesthesia Physician or non-physician provider with pediatric exposure. General anesthesia for all pediatric surgical procedures not requiring invasive monitoring or ventilation. Examples of types of conditions/ procedures Trauma/injuries Resuscitation with advanced life support measures Wound closure Intercostal drainage tube (thoracostomy) Trauma Laparotomy Closed fracture: reduction, traction Open fracture: irrigation, debridement, placement of external fixator Trauma-related amputation Escharotomy, fasciotomy 1st, 2nd degree, skin grafting, simple contractures Burr hole/craniotomy Congenital anomalies General pediatric surgery: Neonatal intestinal obstruction: laparotomy Anorectal malformation: colostomy, anoplasty Hirschsprung’s disease: colostomy Hernia/hydrocele repair: inguinal, umbilical Pediatric urology/gynecology: Relief of urinary obstruction: catherization, suprapubic cystostomy, Male circumcision: neonate, older child, phimosis, paraphimosis Meatal stenosis Orchidopexy: testicular torsion, palpable undescended testes Labial adhesion/agglutination Hydrocolpos/hydrometrocolpos: imperforate hymen, low vaginal septum Pediatric orthopedics: Club foot: non-operative manipulation Infections Infections Thoracic empyema: thoracostomy Appendectomy Laparotomy: typhoid complications, intra-abdominal abscess Drainage of abscess: superficial, pyomyositis, perianal, anorectal Septic arthritis: drainage Osteomyelitis: drainage, débridement Dental surgery: extraction, drainage of abscess, caries Tumors Tumors Biopsy Excision of benign tumors/cysts Others Others Central venous line Intestinal obstruction: intussusception, enteroclysis Foreign bodies: ear, nose, throat, swallowed (Table 5 continued on next page)
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