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Consider pain management - opioid use.  

Track 3:

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Children with Special Health Care Needs

Track leads

Michael Padula

Clinical scenarios/storyboard

A 6 month-old ex-25wk preterm infant with h/o bronchopulmonary dysplasia, complex device needs

  • 6 month-old with post-hemorrhagic hydrocephalus (PHHC) s/p ventriculoperitoneal shunt (VPS), bronchopulmonary dysplasia (BPD) on nasal cannula oxygen
  • s/p Nissen and g-tube: gastric-tube feedings: Neosure with additives 85 mL bolus q 4hour during day, continuous feeds 25mL/hr for 10 hours overnight 
  • presents to (non-primary) Emergency Department with fever & respiratory distress
  • Encounters (scenarios):
  • Discharge from hospital
  • -document device characteristics (tracheostomy, g-tube, VPS), problems (diagnoses), procedures (surgeries), feeding regimen, etc...
  • Primary Care Physician appointment
  • -capture contingency plan (if respiratory distress - consider diuretics)
  • -capture primary and subspecialty providers
  • -show care in medical home (capture details, preferences) --> how care plan is developed
  • Infant presents to Emergency Department
    • Vital Signs: T 38.9 C, RR 75, HR 145, POx 92% on 1.5Lpm NC (up from baseline
    • Assessments:
      • G-tube site: redness and induration with granulation tissue at 3 o'clock (CIMI wound)
      • Resp Distress
  • -review devices, problems, medications, and contingency plans
  • -show use in external/less familiar environments



Track 4: Medication management

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