ASA Update

Update from the Chair of the Committee on Pediatric Anesthesia, the American Society of Anesthesiologists

By Sol Soriano, MD, FAAP
Professor of Anaesthesia, Harvard Medical School
Endowed Chair of Pediatric Neuroanesthesia, Boston Children’s Hospital 

Dr. Soriano

Dr. Soriano

Our community of pediatric anesthesiologists is entrenched in unprecedented times. The COVID-19 pandemic has undoubtedly disrupted our routines and practices. Despite this, these shared challenges strengthen our community and increase dialogue between members of SPA, AAP Section on Anesthesia and Pain Medicine, European Society of Pediatric Anesthesia and Committee of Pediatric Anesthesia (COPA). Initiatives from the American Society of Anesthesiologists and the pediatric anesthesia community have instilled resilience and rapid response to evolving disruptions to the care of our patients.

Response to the COVID-19 Pandemic

Since the onset of COVID-19, the American Society of Anesthesiologists continues to provide leadership and clinical resources on the management of this evolving pandemic.

These practice advisories and Town Halls fittingly complement the pediatric-centric offerings by the SPA and AAP.  The pandemic has also opened lines of communication between our diverse practice settings in the form of the Pediatric Anesthesia Leadership Council discussion group and surveys led and curated by Thomas Long, MD.  A summary of these proceedings has been published in the ASA Monitor and shared with ASA membership.

ANESTHESIOLOGY 2020 Goes Virtual

ANESTHESIOLOGY 2020 will be held virtually on October 2-5, 2020 and feature live content that makes the ASA’s annual meeting the foremost educational forum for anesthesiologists worldwide.

Real-time and interactive sessions in the form of refresher course lectures, panels, research abstracts, problem-based learning discussions and medically challenging cases will provide a familiar feel to this virtual learning platform. The Education Track on Pediatric Anesthesia led by Mary Ellen McCann, MD has compiled a robust slate of pediatric topics that will feature members of the SPA and complement content of the SPA 34th Virtual Annual Meeting, which will be held on the following weekend (October 10-11, 2020).

Practice Advocacy

The ASA has diligently advocated for patient safety and the practice of anesthesiologists. These broad initiatives are outlined in the Society’s website.
The current ASA-Physical Status broadly classifies the patient’s pre-operative medical co-morbidities. In response to the ASA Committee on Economics’ five-year review of the ASA Physical Status, a work group headed by Lynne Ferrari, MD provided its pediatric-specific ASA-PS. Details of this modification have been recently published, (published online ahead of print) and will be vetted at the fall ASA Board of Directors meeting.

Clinical Guidance

Members of COPA continue to share their expertise on the diverse and changing practice of pediatric anesthesia. Debnath Chatterjee, MD and his colleagues on the ASA Committee on Obstetric Anesthesia and the North American Fetal Therapy Network have been deliberating on the best practices for fetal surgery/interventions and will be publishing a consensus statement on Anesthesia for Maternal-Fetal Interventions.

During the COPA meeting in Orlando, Florida last year, Vice Admiral Jerome Adams, MD solicited the committee’s help in addressing the concerning surge in vaping and E-cigarettes in our adolescent patients. Debra Rusy, MD led a working group in producing a consensus statement with input from SPA and the AAP Section on Anesthesiology and Pain Medicine which will be submitted for publication. COPA continues to comment on and support clinical initiatives from other likeminded groups. These include:

  1. We supported the AAP opinion against the practice of “The Single-Clinician–Operator/Anesthetist Model for Dental Deep Sedation/Anesthesia” (Charles Cote and Raeford Brown JAMA Pediatr. 2019;173(12):1127-1128). The American Association of Oral and Maxillofacial Surgeons is advocating for this practice and dental anesthesia assistant national certification that includes the provision of sedation. A joint statement from the ASA, AAP, SPA, the American Society of Dentist Anesthesiologists, and the Society for Pediatric Sedation “endorsed guidelines that recommend that at least two people with specific training and credentials should be present with a pediatric patient undergoing deep sedation or general anesthesia for dental treatment in a dental facility or hospital”.

  2. COPA provided the ASA Anesthesia Quality Institute’s (AQI) NACOR® Committee on Data Definitions with pediatric anesthesia specific data elements and definitions for blood pressure, hyperglycemia and hypoglycemia.

  3. COPA reviewed COVID-19 guidance on the Management of Infants Born to Mothers with COVID-19 and Pediatric BLS and PALS guidance for COVID-19 positive patients from the AAP and American Heart Association, respectively.

The ASA is 52,000 members strong and continues to be a leader in patient safety and an influential advocate for our specialty. COPA is indebted to Mary Dale Peterson, MD the President of the ASA and a card-carrying pediatric anesthesiologist for her tireless and inspiring leadership, especially during the ongoing pandemic.

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