Caring for the Ventilator Dependent Child
Lýsing:This book is an important new resource for clinicians caring for ventilator dependent...
9.690 kr.
Lýsing:
This book is an important new resource for clinicians caring for ventilator dependent children, who often have complex health care needs, are supported by advanced technology and are at high-risk of serious complications. Despite the complicated health care needs of children who rely on chronic respiratory support, there are few guidelines and little evidence available to guide the clinicians who care for these patients.
This book covers the many aspects involved in the care of these complex children, with input from experts in the fields of pediatric pulmonology, intensive care, ethics, respiratory therapy, and nursing. In depth chapters provide an introduction to the use of chronic invasive and non-invasive ventilation in children and describe and review what is known about methods of delivering ventilator support, care of the chronically ventilated patient in the community , use of chronic ventilator support in patients with disorders commonly leading to respiratory failure and outcomes for patients and their caregivers.
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- Útgáfudagur: 2016-07-12
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- Format:Page Fidelity
- ISBN 13: 9781493937493
- Print ISBN: 9781493937479
- ISBN 10: 1493937499
Efnisyfirlit
- Dedication
- Preface
- Acknowledgments
- Contents
- Contributors
- Chapter 1: Chronic Ventilator Support in Children: Why, Who, and When
- Introduction
- Why?
- Who?
- When?
- Conclusion
- References
- Chapter 2: Non-Invasive Mechanical Ventilation in Children: An Overview
- Hypoventilation
- Children with Normal Lung and Respiratory Pump Function with Abnormal Respiratory Drive
- Children with Lung Disease and/or Respiratory Pump Impairment with Normal Respiratory Drive
- Evaluation of Ventilation and CO2 Homeostasis
- Hypoventilation
- Noninvasive Treatment of Hypoventilation
- Continuous Positive Airway Pressure
- Bi-level Positive Airway Pressure
- High-Flow Nasal Therapy
- Noninvasive Positive Pressure Ventilation During Wakefulness
- Introducing Noninvasive Positive Pressure Ventilation
- Benefits of Noninvasive Positive Pressure Ventilation
- Complications of Noninvasive Ventilation
- Future Considerations
- References
- Introduction
- Ventilator Settings and Mechanics of Breathing
- Modes of Mechanical Ventilation
- Application of Different Modes of Mechanical Ventilation
- Characteristics of Home Ventilators
- Complications of Invasive Home Mechanical Ventilation
- Outcomes of Children Supported by Positive Pressure Ventilation via Tracheostomy
- Conclusion
- References
- Introduction
- Before Consent
- Bridge or Destination?
- What Is the Role of Nonclinical Factors in the Decision?
- Are Community Supports in Place?
- The Informed Consent Process
- During Chronic Care of the Child and Family
- Special Considerations in Special Populations
- Teenagers with Intact Cognition
- Infants with Severely Damaged Cognition or Multiple Sensory Deficits
- Before Consent
- What Children on Chronic Ventilation and Their Families Want and Need
- What Is Palliative Care and Why It Is Applicable to Children on Chronic Ventilation and Their F
- The Challenges of Palliative Care and Advance Care Planning
- Addressing These Challenges and Talking About End-of-Life Topics
- References
- Introduction
- Benefits of Going Home
- Enhanced Psychosocial Development and Quality of Life
- Reduced Cost
- Risks of Providing Care at Home
- Risk of Mortality
- Inadequate Home Nursing Care
- Caregiver Stress, Fatigue, and Financial Loss
- Lack of Community and Financial Resources
- Alternative Sites of Care
- Multidisciplinary Team Approach to Discharge
- Team Composition
- Responsibilities of the Team
- Communication with Caregivers
- Pre-discharge Criteria
- Medical Stability of Child
- Identification and Assessment of Caregivers
- Evaluation of Home Environment
- Assessment of Available Financial Resources
- Availability of Home Equipment and Nursing Care
- Primary Care Provider and Pulmonologist
- Home Medical Equipment and Supplies
- Home Nursing
- Preparing the Caregivers
- Establish Expectations
- Caregiver Education
- Caregiver In-hospital Stays
- Transportation Plan
- Emergency Plan for Home
- Preparing the Home
- Preparing for Outpatient Care
- Child Life Education Specialists
- Preparation for School-Based Education
- Outpatient Medical Team and Clinic Visits
- Count Down to Discharge Day
- Communicate Expectations
- Transportation and Arrival Home
- Barriers to Discharge
- Future Needs
- References
- Chapter Objectives
- Why Is This Chapter Important?
- Introduction to Care Models for Ventilator-Dependent Children
- The Medical Home for the Ventilator-Dependent Child
- How the System of Healthcare Appears to the Ventilator-Dependent Child
- Ensuring Family-Centered Care for the Ventilator- Dependent Child
- National Priorities: The Maternal and Child Health Bureau Six Core Outcomes for CYSHCN
- Operationalizing Care Models for Ventilator-Dependent Children: The Current State
- Co-Management between Primary and Specialty Care: Building the Family-Centered Gold Standard
- Implementation of Collaborative, Co-Management Care between Primary and Subspecialty Care
- Summary
- References
- Introduction
- The Importance of the Care Team
- Respiratory Care in the Outpatient Clinic
- Smoking and Secondhand Smoke
- Infection
- Cardiology
- Orthopedic Problems/Scoliosis
- Nutrition in Patients Requiring Chronic Ventilator Support
- Dentistry
- Social Work and Community Resources
- Transition to Adult Care
- References
- Introduction
- Preparation for Mechanical Ventilation of a Child at Home
- Proper Preparation of Caregivers
- Preparation of Family Caregivers
- Preparation of Homecare Nurses
- Preparation by Nursing Agencies
- Monitoring Mechanically ventilated Children in the Home
- Monitoring Devices
- The Human Factor
- Nurses
- Family Caregivers
- Alternate Caregivers
- Preventing Accidental Deaths of Ventilator-Dependent Children in the Home
- Proper Emergency Response by Caregivers
- Psychosocial Aspects of Care in the Home
- Achieving Normalcy
- Traveling Outside of the Home
- Legal Issues
- Outcomes
- Mortality Rates
- Barriers to Improving Outcomes
- Interventions for Improving Outcomes
- Summary
- References
- Introduction
- The Mechanical Ventilator
- Ventilators
- Ventilator Alarms
- Low-Pressure Alarms
- Low Exhaled Minute Volume Alarm
- High-Pressure Alarms
- High Exhaled Volume Alarm
- Apnea Alarm
- Disconnect Alarm
- Low Battery Alarm
- Low Power/Power Failure Alarm
- Ventilator Circuits
- Batteries
- Interface
- Tracheostomy Tubes
- Noninvasive Ventilation Interfaces
- Humidification
- Heated Humidifiers
- Heat Moisture Exchangers
- Humidification with Noninvasive Ventilation
- Oxygen
- Liquid Oxygen System
- Oxygen Concentrators
- Oxygen Cylinders
- Monitoring
- Pulse Oximeter
- End-tidal CO2 Monitor
- Apnea Monitor
- Additional Equipment in the Home
- Suction Machine
- Resuscitation Bag
- Resources When Equipment Fails
- Emergency and Disaster Preparedness
- Emergency Generators
- Emergency Plans
- Summary and Future Research Needs
- References
- Background
- A Brief Primer on Principles of Respiratory Aerosol Delivery
- Delivery Devices
- Patients Receiving Mechanical Ventilation Who Do Not Tolerate Being Disconnected from the Ventila
- Metered-Dose Inhalers
- Nebulizers
- Patients Receiving Invasive Mechanical Ventilation Who Tolerate Being Disconnected From the Venti
- Metered-Dose Inhaler
- Nebulizers
- Patient Receiving Noninvasive Mechanical Ventilation Who Do Not Tolerate Being Disconnected from t
- Metered-Dose Inhaler
- Nebulizer
- Patients Receiving Noninvasive Mechanical Ventilation Who Tolerate Being Disconnected from the Ve
- Clinical Key Points
- Summary
- References
- Introduction
- Obstructive Sleep Apnea and Continuous Positive Airway Pressure
- Noninvasive Ventilation
- The Importance of Knowledge About Adherence to Respiratory Support
- Principles of Adherence in Children and Adolescents
- Adherence to CPAP in Children
- Functional Correlates of Adherence to CPAP
- Patterns of Adherence to CPAP
- Predictors of Adherence to CPAP
- Age
- Comorbidity
- Parent and Family Factors
- Barriers to Use
- Disease Modification
- Technical Variables
- Adherence to Noninvasive Ventilation
- Improving Adherence
- Conclusions
- References
- Introduction
- Pathophysiological Mechanisms of OSAS
- Functional Considerations
- Ventilatory and Chemical Drive
- Ventilatory Response to Inspiratory Loading
- Arousal
- Neuromotor Tone and Its Evaluation
- Anatomical Considerations
- Infancy
- Childhood
- Adolescence
- Functional Considerations
- Mechanism of PAP Ventilation in OSAS
- Forms of PAP Ventilation and Technical Considerations
- Indications for PAP Ventilation
- OSAS in Otherwise Healthy Children
- OSAS Associated with Obesity
- Residual OSAS After AT
- OSAS Associated with Laryngomalacia
- OSAS Associated with Craniofacial Malformations and Genetic Disorders
- Craniosynostosis
- Pierre Robin Sequence
- Achondroplasia
- Down Syndrome
- Prader-Willi Syndrome
- OSAS Associated with Altered CNS Function
- Neuromuscular Disorders
- Congenital Central Hypoventilation Syndrome
- Chiari Malformation
- Cerebral Palsy
- Miscellaneous
- Mucopolysaccharidosis (MPS)
- OSAS in Children That Are Not Candidates for AT
- OSAS in Otherwise Healthy Children
- Medications
- Treatment with Nasal Insufflation
- Nasal Expiratory Positive Airway Pressure (EPAP) Device
- Oral Appliances
- Rapid Maxillary Expansion
- Complex Upper Airway Surgery
- Tracheotomy
- Introduction
- Pathophysiology
- Assessment of Respiratory Function in Neuromuscular Disorders
- Sleep Studies
- Aims of Ventilatory Support
- Sleep Studies
- Titrating Settings
- Monitoring Efficacy of Ventilator Support
- Acute Chest Infections
- Cough Assistance
- Progression to Tracheostomy Ventilation
- Palliative NIV/Ethics
- Epidemiology of Bronchopulmonary Dysplasia
- Respiratory Phenotypes in the Preterm Child with BPD
- Ventilator Management in the Preterm Child with Bronchopulmonary Dysplasia
- Other Home Ventilation Management Issues
- Comorbidities Affecting Ventilator Management
- Conclusions
- References
- Introduction
- Mechanisms of Injury
- Traumatic Brain Injury
- Spinal Cord Injury
- Thoracic Injuries
- Development of Chronic Respiratory Failure Following Trauma
- Reduce the Respiratory Load
- Increase Ventilatory Muscle Power
- Improve Central Respiratory Drive
- Philosophy of Chronic Ventilatory Support
- Modes of Ventilation
- Portable Positive Pressure Ventilator via Tracheostomy
- Noninvasive Positive Pressure Ventilation
- Diaphragm Pacing via Phrenic Nerve Stimulation and Diaphragm Muscle Pacing
- Respiratory Treatments
- Bronchodilators/Beta Adrenergic Agonists
- Respiratory Muscle Training
- Nutrition
- Dysphagia Evaluation
- Follow-Up Studies and Monitoring
- Polysomnography
- Echocardiogram
- Monitoring for Sleep Issues and Sleep-Related Breathing Disorders
- Monitoring for Scoliosis and Restrictive Lung Disease
- Conclusion
- References
- Pathophysiology
- Genetics
- Effect of Sleep State
- Mechanoreception
- Clinical Presentation
- Autonomic Dysfunction
- Late-Onset Central Hypoventilation Syndrome with Hypothalamic Dysfunction
- Evaluation and Diagnosis
- Assessment of Hypoventilation
- Screening for Autonomic Dysfunction
- Management
- Goals of Care
- Ventilation
- Positive Pressure Ventilation via Tracheostomy
- Noninvasive Bi-level Positive Airway Pressure
- Negative Pressure Ventilation
- Diaphragmatic Pacing
- Ongoing Care and Monitoring
- Screening for Medical Comorbidities Associated with CCHS
- Genetic Counseling
- Home Care and Nursing Support
- Social Issues and Quality of Life
- Perioperative Care
- Pregnancy
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- Útgáfuár : 2016
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