P-cats list_en & fr.xls
Paediatric Canadian Access Targets for Surgery (P-CATS)
*Wait 1 is defined as the time from referral to a specialist to the initial specialist consultation.
**Wait 2 is defined as the time between the date on which a decision is made to proceed with surgery and the surgery date.
P-CATS Prioirty Classification TablePriority Classification
Canadian Paediatric Surgical Wait Times (CPSWT) Project

Prosthetic valve/conduit failure - Chronic
Transposition(L) - Corrected(AVD) - Acute
Transposition(L) - Corrected(AVD) - Chronic

Dental Caries - moderate risk medical status
Advanced Dental Caries: visible carious lesions and/or pain - low
risk medical status Advanced Dental Caries: visible carious lesions and/or pain -
moderate risk medical status Advanced Dental Caries: visible carious lesions and/or pain -
Pericoronitis (impacted molar) - low risk medical status
Pericoronitis (impacted molar) - moderate risk medical status
Pericoronitis (impacted molar) - high risk medical status
Infection (hard and/or soft tissue) - low risk medical status
Infection (hard and/or soft tissue) - moderate risk medical
Infection (hard and/or soft tissue) - high risk medical status
Dental Abscess/Pulp Necrosis - low risk medical status
Dental Abscess/Pulp Necrosis - moderate risk medical status
Dental Abscess/Pulp Necrosis - high risk medical status
Osteomyelitis - moderate risk medical status
Examination Under Anaesthesia - Comorbidity and/or discomfort
Examination Under Anaesthesia - Unable to examine

Suspected Benign Lesions (hard and/or soft tissue)
Suspected Malignant Lesions (hard and/or soft tissue)
Ankyloglossia - with breastfeeding issues
Neck mass - No suspicion of cancer (including Thyroglossal,
Neck mass inflammatory - Chronic (atypical mycobacterial)
Cystic mass (lymphangioma) with obstruction
Cystic mass (lymphangioma) without obstruction
Diaphragmatic Abnormalties - Symptomatic
Diaphragmatic Abnormalties - Asymptomatic

Other abdominal wall hernias (Epigastric, Incisional, Ventral
Inguinal hernia: Incarcerated, Non-Reducible
Inguinal hernia: < 1 year non-incarcerated
Inguinal hernia: > 1 year non-incarcerated
Gallbladder disease - symptomatic: Chronic
Disease potentially requiring splenectomy
Disease potentially requiring urgent splenectomy (eg ITP with
Pancreatic Disease (no malignant potential)
Upper GI Bleed, Perforation, Gastric volvulus - Acute
Anorectal malformations without obstruction
History of perforated appendicitis managed nonoperatively

Acute scrotum - Testicular torsion & Infection
Vascular/Lymphatic Malformation - Symptomatic
Vascular/Lymphatic Malformation - Asymptomatic
Need for venous access devices - Non Urgent
Removal of hardware/venous acces devices/PEG - Urgent
Removal of hardware/venous acces devices/PEG - Non Urgent
D&C for Incomplete Abortion: Hemodynamically Stable
D&C for Missed Abortion: Hemodynamically Stable
Surgical treatment for ectopic pregnancies
Non-Obstructive or Asymptomatic Obstructive Anomalies
Longitudinal Vaginal Septums, Hymenal anomalies

Laparoscopy for acute pelvic pain (non torsion)
Insertion of IUD (for menstrual suppression), Non Urgent
EUA, Cystoscopy, Vaginoscopy - Other: non-infectious, non
Examination under anesthesia (EUA) or Vaginoscopy for vaginal
D&C for Menorrhagia: Heavy bleeding, unresponsive to
medicaltherapy and hemodynamically unstable
Spinal Cord Tumour: With neurological deficit
Spinal Cord Tumour: Without neurological deficit
Brain StructuresDevelopmental Malformations:
Chiari Malformation Type 2 - Symptomatic Major
Brain StructuresDevelopmental Malformations:
Chiari Malformation Type 2 - Symptomatic Minor

Brain StructuresDevelopmental Malformations:
Brain StructuresDevelopmental Malformations:
Craniosynostosis: Non-syndromic: < 6 months
CraniofacialDevelopmental Malformations:
Craniosynostosis: Non-syndromic: > 6 months
CraniofacialDevelopmental Malformations:
CraniofacialDevelopmental Malformations:
CraniofacialDevelopmental Malformations:
Congenital Anomaly of the Spine - new or progressive
Congenital Anomaly of the Spine - without neurological
Tethered Spinal Cord - new or progressive deficit
Tethered Spinal Cord - asymptomatic/neurologically stable
Arteriovenous malformations: Ruptured Stable
Arteriovenous malformations: Ruptured Unstable
Arteriovenous malformations: Stable (present with seizures)
Baclofen pump failure/Baclofen withdrawal

Amblyogenic Lid and Orbital Lesions < 2 years
Amblyogenic Lid and Orbital Lesions > 2 years
Lid malposition without corneal involvement
Retinopathy of prematurity: Any Stage - Zone 1
Retinopathy of prematurity: Stage 2 or 3 - Zone 2 with plus
Retinopathy of prematurity: Stage IV & V
New Strabismus (with or without diplopia) - Acute
Fascial Space Infection - high risk medical status
Fascial Space Infection - moderate risk medical status

Fascial Space Infection - low risk medical status
Infected jaw pathosis - high risk medical status
Infected jaw pathosis - moderate risk medical status
Infected jaw pathosis - low risk medical status
Osteomyelitis - moderate risk medical status
Residual Oro-Nasal Fistula: Vestibular or Palatal
Cleft septorhinoplasty, Cleft lip/nose revisionary surgery
Speech Delay - Velopharyngeal insufficiency
Ankyloglossia - with breastfeeding issues
Skeletal-Facial Deformities Requiring Orthognathic Procedures:
Maxilla/Mandible/Genioplasty/Coronoidectomy
Skeletal-Facial Deformities Requiring Orthognathic Procedures:
Airway issues: Treacher Collins, Micrognathia
Vascular anomalies with functional issues
Vascular anomalies without functional issues

Advanced Dental Caries: visible carious lesions and/or pain -
Advanced Dental Caries: visible carious lesions and/or pain -
Advanced Dental Caries: visible carious lesions and/or pain - low
Supernumerary tooth - with or without associated pathosis
Examination Under Anaesthesia - Unable to examine
Suspected Benign Lesions (hard and/or soft tissue)
Suspected Malignant Lesions (hard and/or soft tissue)
Osteoradionecrosis Maxilla & Mandible

Hypertrophied Turbinates Causing Nasal Obstruction
Benign Lesions (nostril, oral, lip, facial, tongue, ear etc.)
Malignant Lesions (nostril, oral, lip, facial, tongue, ear etc.)
Post Ablative Defect: Maxilla and Mandible

Erb’s Palsy (specific to orthopaedic surgery)
Developmental Dysplasia of hip - < 18 months
Developmental Dysplasia of hip - 18 months - 3 years
Developmental Dysplasia of hip - > 3 years
Slipped Capital Femoral Epiphysis - Stable
Slipped Capital Femoral Epiphysis - Unstable
Congenital anomalies of the spine - Stable (unlikely to progress)
Congenital anomalies of the spine - Unstable (likely to progress)
Other elective spinal disorder - neurologically stable
Other elective spinal disorder - neurologic compromise (urgent)
Other elective spinal disorder - neurologic compromise (non-
Spinal Injuries affecting the spinal cord - Progressive
Spinal Injuries not affecting the spinal cord - Not progressive
Spondylolisthesis - Stable (unlikely to progress)
Spondylolisthesis - Unstable (likely to progress)

Minor variants of normal orthopaedic development (flexible flat feet, in-toeing, out-toeing, bow legs in children < 3yrs of age,
knock knees in children <10yrs of age, lordosis, minor scoliosis curves - less than 20 degree curve)
Malignant/Aggressive (after new adjuvant therapy)
Neuromuscular disease - diagnostic biopsy
Wound care - delayed primary or secondary closure
Patellar Subluxation - (recurrent/chronic)
Fibular Hemimelia, Proximal Femoral Focal Deficiency, Tibial
Charcot Marie Tooth Syndrome, Mitochondiopathy,

Laryngeal stenosis with significant airway issues
Laryngeal stenosis without significant airway issues
Papilloma of larynx: with acute airway obstruction
Papilloma of larynx: without significant airway obstruction
Removal of tonsils and/or adenoids: For obstructive symptoms
Removal of tonsils and/or adenoids: If severe OSA
Removal of tonsils and/or adenoids: With recurrent infection
Retropharyngeal & parapharyngeal abscess
Laryngoscopy/Bronchoscopy for diagnosis or surveillance
without significant airway obstructionLaryngoscopy/Bronchoscopy for diagnosis or surveillance with
Lymphatic malformation: without compromise
Mycobacterial infection: if skin compromised
Neck mass - No suspicion of cancer (including Thyroglossal,
Speech Delay - Velopharyngeal insufficiency
Chronic Suppurative Otitis Media/Chronic Mastoiditis with or

SNHL Requiring Cochlear Implant after meningitis
Myringotomy & tubes for recurrent Otitis Media
Myringotomy & tube for Otitis Media with effusion
Rehabilitation of conductive hearing loss (BAHA)
Hypertrophied Turbinates Causing Nasal Obstruction
Benign Lesions (nostril, oral, lip, facial, tongue, ear etc.)

Secondary reconstruction: Functional concerns
Secondary reconstruction: Social concerns
Cleft septorhinoplasty, Cleft lip/nose revisionary surgery
Speech Delay - Velopharyngeal insufficiency
Other Congenital Hands & Upper Extremity - Complex
All other Congenital Hands & Upper Extremity
Airway issues: Treacher Collins, Micrognathia
Vascular anomalies with functional issues
Vascular anomalies without functional issues
Wound care - primary and/or delayed closure

Acute Scrotum - Testicular Torsion and Infection
Cryptorchidism: Bilateral & non-palpable in newborn
Cryptorchidism: Bilateral & palpable in newborn
Inguinal Hernia: < 1 year of age non-incarcerated
Inguinal Hernia: > 1 year of age non-incarcerated
Inguinal hernia: Both age groups, incarcerated non-reducible

UPJ /UVJ obstruction/Ectopic Ureter: Asymptomatic
UPJ /UVJ obstruction/Ectopic Ureter: Symptomatic
Ureterocoele: Septic (if no response to antibiotics after 48 h)
Ureterocoele: Septic (if response to antibiotics after 48 h)
Renal / ureteric stones: Obstructed (uncontrolled pain)
Renal / ureteric stones: Obstructed (controlled pain)
Source: http://www.waittimealliance.ca/waittimes/P-CATS-List_en.pdf
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