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

History and Physical

Screen children for health issues, comorbidities, and important family histories
Determine whether patient requires surgery
Evaluate for any factors that may prohibit surgery at the ASC

Prior to Scheduling Surgery

Chief Complaint	Snoring Obstructive sleep apnea (OSA) Recurrent infection Sleep disordered breathing
History Components	Birth (prematurity, full term) Previous medical or surgical history Bleeding or anesthesia complications (example) Sleeping habits Pausing/gasping, restless sleep, sleepiness during the day, bedwetting Difficulty swallowing/choking on foods Family history of bleeding or anesthesia complications s/a (malignant hyperthermia)
Physical	Appearance: obese, overweight, underweight (BMI) Size of tonsils (grades 1-4) Airway status/assistive devices (what criteria do you use) Musculoskeletal status Respiratory status Cardiac status

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.