perinatal and neonatal health- Dr Carter and Linebarger

Question 1

what were some things that reduced neonatal mortality and post neonatal mortality?

Answer 1

antibiotics, and better care of children, and better ways to cure infectious disease

Question 2

what is the incidence of gastrochesis, or omphalacele?

Answer 2

1 in 3000-5000 births

Question 3

what can perinatal palliative care provide?

Answer 3

a safe place to discuss continued goals and wishesin a non judgemental way

Question 4

what are teh stages of finding out a child has a problem?

Answer 4

prenatal diagnosis- discovery
Questions/research
coping and coices- anticipatory grief
birth
life and love- learning what is needed, letting go
bereavement

Question 5

what are some challenges of the setting of a child with a problem?

Answer 5

the chance for “success” stories

• some think its insane NOT to try EVERYTHING possible to cure the baby
• have to look at what is beneficial, and what is futile

Question 6

what are the realationship challenges in these situations?

Answer 6

as a doctor you need to find a midpoint in being a “fixer” and a compassionate flexible partner

Question 7

what are some things that you NEED to tell the family, or discuss with the family?

Answer 7

• they need to hear and prepare for the full spectrum of possible outcome
• feel cared for
• they need time to make difficult decisions

Question 8

what is palliative pediatric palliative care?

Answer 8

active total care of the childs body, mind, spirit, and giving support to the family

Question 9

when does palliative care start, and end/

Answer 9

begins with the diagnosis of illness, and continues regardless if the child recieves treatment for the disease or not

Question 10

what are the goals of pediatric palliative care?

Answer 10

to alleviate a childs physical, psychological, and social distress

Question 11

what should you always adress, on an individual basis with kids in palliative care?

Answer 11

their quaility of life, different things make life “worth it” for different people

Question 12

what is the “functional” definition of pediatric palliative care

Answer 12

care for children with life-limiting or life threatening illness
- is interdisciplinary

Question 13

what are some things that you need to find out if the family knows?

Answer 13

• how much they know and understand
• what is important for the family
• allow silence for the family, and LISTEN

Question 14

what are some things you can say to console a family? what shoul dyou avoid saying?

Answer 14

• this must be really difficult for you
• i see that your hearts are breaking

DO NOT SAY- i know how you feel

Question 15

what are some thinsg that you can focus on when you ( the doctor) and the family are preparing together?

Answer 15

• weigh the benefits and burdens
• have goals
• doing things “to” or “for” the child
• give the family TIME
• focus on comfort