Community Primary referral hospital Secondary Hospital Tertiary Children’s facility/primary hospital hospital health center Trauma/Injuries Resuscitation with Resuscitation with advanced NOT ALL BURNS up to 10% All burns All – basic life support life support measures TBSA (excluding inhalation, measures Surgical airway face, H&N, flexural, perineal, All trauma Wound care: Wound closure neonatal, digital or hands) suturing, dressing Intercostal drainage tube NOT ALL TRAUMA Acute Fracture: closed, Trauma Laparotomy – injury with acute limb or life non-displaced Closed fracture: reduction, threatening injury Burns: 1st degree traction (stabilizing procedures, Open fracture: irrigation, damage control operations) debridement, placement of external fixator Colostomy and other Trauma-related amputation abdominal emergency Escharotomy, fasciotomy surgeries that can be 1st, 2nd degree, skin performed by an adult grafting, simple contractures general surgeon Burr hole/craniotomy Hernia > 1 year-old Congenital Male circumcision: General pediatric surgery: All corrective procedures All All anomalies normal prepuce, Neonatal intestinal determined by available using plastic guide obstruction: laparotomy expertise device (e.g. Anorectal malformation: Plastibel) colostomy, anoplasty Hirschsprung's disease: colostomy Hernia/hydrocele repair: inguinal, umbilical Pediatric urology/gynecology: Relief of urinary obstruction: catherization, vesicostomy Male circumcision: neonate, older child, phimosis, paraphimosis Meatal stenosis Orchidopexy: testicular torsion, palpable undescended testes Labial adhesion/agglutination Imperforate hymen Pediatric orthopedics: Club foot: non-operative manipulation Infections Superficial abscess: Infections All All drainage Thoracic empyema: tube thoracostomy Appendectomy Laparotomy: typhoid complications, abscess Drainage of abscess: superficial, pyomyositis, perianal, anorectal, Septic arthritis: drainage Osteomyelitis: drainage, débridement Dental surgery: extraction, drainage of abscess, caries
Community facility/primary health center Primary referral hospital Secondary Hospital Tertiary hospital Children’s hospital Trauma/Injuries Resuscitation with basic life support measures Wound care: suturing, dressing Fracture: closed, non-displaced Burns: 1st degree Resuscitation with advanced life support measures Surgical airway Wound closure Intercostal drainage tube 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 NOT ALL BURNS – up to 10% TBSA (excluding inhalation, face, H&N, flexural, perineal, neonatal, digital or hands) NOT ALL TRAUMA – Acute injury with acute limb or life threatening injury (stabilizing procedures, damage control operations) Colostomy and other abdominal emergency surgeries that can be performed by an adult general surgeon Hernia > 1 year-old All burns All trauma All Congenital anomalies Male circumcision: normal prepuce, using plastic guide device (e.g. Plastibel) 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, vesicostomy Male circumcision: neonate, older child, phimosis, paraphimosis Meatal stenosis Orchidopexy: testicular torsion, palpable undescended testes Labial adhesion/agglutination Imperforate hymen Pediatric orthopedics: Club foot: non-operative manipulation All corrective procedures determined by available expertise All All Infections Superficial abscess: drainage Infections Thoracic empyema: tube thoracostomy Appendectomy Laparotomy: typhoid complications, abscess Drainage of abscess: superficial, pyomyositis, perianal, anorectal, Septic arthritis: drainage Osteomyelitis: drainage, débridement Dental surgery: extraction, drainage of abscess, caries All All
1-s2.0-S0022346817306292-mmc2.docx