|Pediatric Adenotonsillectomy for Obstructive Sleep Apnea Syndrome (OSAS): Observation Care|
Inpatient and Surgical Care (ISC)
|BCBST last reviewed December 21, 2016*|
Added: Exceptions may be required to comply with EPSDT & BlueCare® regulations. Observation Care Admission Criteria
Observation Care Discharge Criteria
- Observation may be appropriate for a patient 3 years of age or less with a diagnosis of OSAS who has risk factors for postoperative respiratory complications which include 1 or more of the following:
- Severe OSAS on polysomnography
- Cardiac complications of OSAS (e.g., right ventricular hypertrophy)
- Failure to thrive
- Recent respiratory infection
- Craniofacial anomalies
- Neuromuscular disorders. See General Criteria: Observation Care guideline.
- Discharge to nonacute care follow-up is appropriate for a patient with ALL of the following:
- Procedure is completed
- Physiologic recovery
- Stable vital signs
- Stable respiratory status
- Patient alert
- Temperature appropriate
- Postoperative effects resolved or managed
- Voiding status acceptable
- Competent person available to accompany patient
- No complicating features
American Academy of Pediatrics. (2012, September). Clinical Practice Guideline: Diagnosis and management of childhood obstructive sleep apnea syndrome. Retrieved August 28, 2013 from http://pediatrics.aappublications.org/content/130/3/576.full.pdf.
American Academy of Otolaryngology – Head and Neck Surgery. (2011, August). Clinical Practice Guideline: Tonsillectomy in children. Retrieved August 11, 2011 from http://oto.sagepub.com/content/144/1_suppl/S1.full.pdf+html.
American Society of Anesthesiologist. (2014, February). Practice guidelines for the perioperative management of patients with obstructive sleep apnea. Retrieved September 7, 2016 from http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917935.
American Society of Anesthesiologist. (2011, October). Statement on practice recommendations for pediatric anesthesia. Retrieved September 17, 2012 from http://www.asahq.org/For‐Members/Standards‐Guidelines‐and‐Statements.aspx.
BlueCross BlueShield of Tennessee network physicians. September – December 2016.
Pediatrics. (2016, June). Guidelines for monitoring and management of pediatric patients during and after sedation for diagnostic and therapeutic procedures: Update 2016. Retrieved September 7, 2016 from http://pediatrics.aappublications.org/content/early/2016/06/24/peds.2016‐1212.
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