T&A Triage with or without Preoperative Polysomnography Clinical Pathway – Inpatient and Outpatient Specialty Care

Determine Disposition

Post-operative Disposition

Direct Admit to PICU

  • Age: < 1 y/o or < 2 y/o and history of < 32 weeks premature
  • Comorbid conditions:
    • Cardiac - Pulmonary hypertension or requires cardiac/C4 anesthesia
    • Respiratory - Intubation or acute mechanical ventilation via tracheostomy tube, known difficult/critical airway, baseline home ventilator, active wheezing or active cold symptoms
    • FiO2 > 40% by mask
    • Continuous NP airway needed

Admit to Inpatient Medical/Surgical Unit

  • FiO2 < 40% by mask
  • Obesity (BMI > 35)
  • In phase II recovery
  • Monitoring/Treatment:
    • Continuous pulse oximetry while asleep
    • Monitor for hemorrhage
    • Continue pain control with PO medications

Admit to PICU or 8 South

  • BiPAP/CPAP dependence or oxygen requirement
    • If on baseline NIPPV, may be appropriate for 8 South
    • Admit to PICU if there is surgical preference not to place on baseline support, or if the patient is on NIPPV support above baseline
    • Disposition to be determined under the direction of ENT, ARC, and Pulmonary