am honored to become the newest chair of the ASA Committee on Pediatric Anesthesia (COPA). I wish to thank Carolyn F. Bannister, M.D., for her many years of outstanding service to this committee, which is only one of her many contributions to ASA and its members.

According to the ASA Bylaws, the responsibilities of this committee are to: “promote study and investigation in the field of pediatric anesthesia; encourage and develop the interest of the membership in pediatric anesthesia; review all significant developments in the field of pediatric anesthesia and devise and implement programs to present them to the membership; and maintain liaison with the American Academy of Pediatrics and such other external organizations as may be concerned with pediatric anesthesia.”

Starting in reverse order, pediatric anesthesiologists may be unique among the anesthesiology subspecialties in terms of their professional representation. Besides the important role of ASA, pediatric anesthesiologists may belong to both the Society for Pediatric Anesthesia (SPA), a specialty society recognized by — but organized outside of — ASA, and the American Academy of Pediatrics (AAP) Section on Anesthesiology and Pain Medicine. The role and function of each of these organizations is somewhat unique. It is my belief, however, that this structure gives pediatric anesthesiologists an opportunity to bring great attention to issues of importance in the subspecialty and to attack these issues from multiple angles.

As part of the pediatric theme of this issue, SPA President Francis X. McGowan, Jr., M.D., summarizes the structure and function of that rapidly growing organization on page 25. Also working in the area of education and advocacy, the AAP Section on Anesthesiology and Pain Medicine is ably led by Thomas J. Mancuso, M.D. While the smallest of the three anesthesiology-related organizations, the AAP Section has a long and distinguished track record. The first guidelines on sedation in children came from AAP and the Section on Anesthesiology and Pain Medicine. AAP also led the way with its publication of guidelines for the pediatric perioperative anesthesiology environment. In the December 2004 issue of Pediatrics, the Section on Anesthesiology and Pain Medicine published a report on do-not-resuscitate orders for pediatric patients who require anesthesia and surgery.

ASA’s leaders have spent considerable effort in the past four years examining ways to strengthen the relationship between ASA and all of the anesthesiology subspecialty societies. Recently COPA and the leaders of SPA and the AAP Section have recommitted to examining means in which we can work together to further the anesthetic care of children and the interests of our members. The most recent example of these efforts was a joint letter to the Joint Commission on Accreditation of Healthcare Organizations regarding its Sentinel Event Alert on intraoperative awareness and that document’s implications for pediatric anesthesiologists. The three organizations also are working with other ASA committees to monitor the situation regarding the continued availability of traditional intravenous catheters, which is summarized on page 14 of this NEWSLETTER.

Where do we go from here? The possibilities sometimes seem endless. On the education front, members of the committee are working on what might become a standard curriculum for the pediatric portion of anesthesiology residencies. While not trying to usurp the responsibilities of other organizations in this regard, it is hoped that this effort will be seen as another resource for resident education in pediatric anesthesiology.

For several years, the committee has discussed the development of a pediatric anesthesiology “best practices” document along the lines of the practice guidelines in obstetric anesthesia published by ASA. In my short tenure as chair, I have been amazed at the number of questions that come in about whether or not ASA or COPA have statements on different aspects of pediatric anesthesia care. It is my hope that the committee can develop a body of questions that can be used as the basis for the formal development of a practice guideline or advisory in this area.

On the financial and reimbursement front, the committee continues to encourage the development of Relative Value Guide codes specific to the delivery of pediatric anesthesia. We also will closely monitor issues related to the Medicaid program, which so heavily impacts all of our practices.

There is one other area that might be deserving of an entire article in a future issue of the NEWSLETTER. This sensitive subject has to do with the evolution of anesthesiology departments in children’s hospitals over the past 15 years. A description of the change from what were predominantly private practices in the past to the academic university practices of the present might be instructive to those dealing with such issues. Many interesting adaptations have taken place that run the gamut from hospitals employing anesthesiologists directly to anesthesiology departments changing mastheads from anesthesiology to pediatrics.

The Committee on Pediatric Anesthesia has been and will continue to be an important conduit for bringing attention to pediatric anesthesiology-related matters. Where possible we will attempt to formulate policies that can be submitted to ASA officers, the Board of Directors and the House of Delegates for approval and implementation. Where appropriate we will confer and coordinate with SPA and the AAP Section on Anesthesiology and Pain Medicine. ASA members are encouraged to contact me or any member of the committee with issues or concerns relevant to the practice of pediatric anesthesiology.

Randall M. Clark, M.D., is President, Rocky Mountain Pediatric Anesthesiology, P.C., Denver, Colorado, and is ASA Director for Colorado.