Pediatric Hospital Medicine 2012

Lessons From The Rehab Unit: Case Studies in the Care of Medically Complex and Technology Dependent Children
Suzanne Prestwich, Glendaliz Bosques
At the conclusion of this session, participants will be able to:

  1. Understand the epidemiology and outcomes of patients with cerebral palsy (CP). Understand nomenclature related to CP and other related terms including spasticity, tone, and dystonia.
  2. Understand medical and surgical management of cerebral palsy.
  3. Understand epidemiology and outcomes of traumatic brain injuries (TBI).
  4. Understand use of Glasgow Coma Scale and Ranchos Los Amigos scale related to severity and recovery from brain injury. Understand specific problems associated with TBI.
  5. Understand epidemiology and outcomes of spinal cord injury (SCI).
  6. Understand American Spinal Injury Association exam.
  7. Understand specific problems related to SCI including neurogenic bowels, neurogenic bladder and autonomic dysreflexia.
  8. Understand additional comorbidities often seen in patients with complex medical needs including seizures, hydrocephalus, infections, and respiratory insufficiency.
  9. Understand the use of medical technology often seen in children with complex medical needs.

Medically complex children constitute a significant portion of hospitalized pediatric patients, resulting in frequent encounters with pediatric hospitalists. They are among the most challenging patients to care for given the chronicity of problems and complex psychosocial issues that often surround these patients. Using interactive cases, we will follow three medically complex patients. Initial discussion of the case will start in the acute care setting. Each patients' underlying condition will be described and acute course of treatment described. The patients will then be followed in the rehabilitation setting where long-term management decisions are often made relating to technology. Shorter cases illustrating encounters between medically complex patients and pediatric hospitalists will be provided. These short cases will review the information learned with the long cases and provide "clinical pearls" regarding management. All sessions will be interactive with the target audience.


 

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