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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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