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Administration/What kind of emergency equipment is needed for children?

QUESTION:

I am a consultant who assists physicians in the development of freestanding ambulatory surgical centers throughout the US. Overall, the licensing requirements tend to be fairly uniform with one exception; there is a tremendous disparity among health department offices regarding requirements for emergency medications and equipment relative to the age of the anticipated patient population-- specifically, pediatric patients.

Most recently we were apprised by one agency official that a pediatric patient is defined as 18 years of age and younger and that in order to treat patients 14 years of age and older (which was our licensing request) the group would still be required to provide "pediatric defibrillator paddles, pediatric emergency medications (unit doses), special resuscitative equipment, pediatric surgical instrumentation and pediatric stretchers." In many other states 14 is considered the cut off for these items, and in some instances it is as low as age 12. Only a few states actually have written codes defining the specific qualifications of a pediatric patient.

Are there any published guidelines from professional organizations, specifically related to anesthesia or peri-operative emergencies, which I can use successfully in dealing with these agencies to provide some level of consistency? I would appreciate any comments and recommendations you may offer.

-- From Mary Parker, Los Angeles, CA

REPLY:

The American Society of Anesthesiologists has published a document, "Pediatric Anesthesia Practice Recommendations", which is found at: http://www.asahq.org/clinical/PediatricAnesthesia.pdf.

In that document, there is a section on equipment and drugs. The requirements for medications and equipment should be based on the age of the patient that is expected to be treated.

-- From Lance Lichtor, M.D., Iowa City, IA

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