Settings of Pedi PT Flashcards
what are 6 reasons for pediatric admission into acute care and what is the primary one
respiratory**
GI
neonatal
orthopedic
neurological
multi-trauma/burns
what are 3 special considerations of pedi acute care
- fast paced setting
- psych impact of caring for critically ill child and family
- interprofessional team
what is a consideration of pedi acute care that you need to be vigilant
lab values
- have to know the guidelines and what pt sx to monitor
what lines in a pedi acute care setting might you see and what are considerations
peripheral IV (<6 days)
PICC line (>1 week)
non-tunneled CVCs
- avoid extreme motions which may disturb line
need to know purposed of line
what are tubes in a pedi acute care setting and what are considerations
feeding tubes
- NG (mouth to stomach)
- surgical placement G/J/G-J tube
respiratory tubes
- nasal canula
- CPAP
BiPAP
endotrach tubes
tracheostomy
chest tube
- monitor c/o or sx of pain in area, integrity of seal, help w accurate measurements of drainage
considerations
- c/o pain, dc, or drainage
cautious of gait belt position
what are drains in a pedi acute care setting
post surgical dialysis
LVAD
ECMO
what are 2 scales to assess pain in pedi acute care
FACES scale
FLACC behavioral pain scale
what are pharmacologic management options in a pedi acute care
PCA
young children may go under-medicated -> nursing or family PCA
why might it be helpful to talk to caregiver before starting to work w the child
help you to read the nonverbals
what cases do you typically see PCA use in pedi acute care (3)
post op
sickle cell dz
burns
what are general pedi acute care precautions and contraindications (3)
specific
DVT
infectious processes
what are examples of specific precautions/contraindications in pedi acute (4)
orthopedic
neurological
procedural precautions
- bed rest post lumbar puncture
hematological
- lab values
DVT precautions in pedi vs adult
no difference!
- very similar
- as you would think
what are 3 common hospital infections and what infections are a higher risk in the pedi population or CF population
MRSA
VRE
Cdiff
babies under 1yo @ high risk for RSV
CF: Bcc & psudonomas aeruginosa
what are clinical reasoning components for frequency and duration of PT in acute care (4)
chronicity of condition
rate of expected progress
risk for complications d/t immobility requiring skilled PT intervention
dc needs
type and frequency/duration of physical therapy services for chronic impairments, known developmental delays, medical conditions, and/or non rehab based needs
consult
1-2 visits total
type and frequency/duration of physical therapy services for chronic impairments, known developmental delays, medical conditions, and/or limited ability to participate in functional activities for those who are admitted for non-rehab needs
occasional
1-2x /wk
type and frequency/duration of physical therapy services for no new documented loss of skill or new impairments, w little foreseeable potential for progress toward functional goals
consult
1-2 visits total
type and frequency/duration of physical therapy services for new or chronic impairments, medical conditions, and/or functional limitations
regular
3-4x /wk
type and frequency/duration of physical therapy services for a potential for weekly/monthly progress toward functionally based goals
occasional
1-2x/wk
type and frequency/duration of physical therapy services for acute loss of functional skills d/t new illness/injury and are making significant gains in functional status
intense
>/= 6x/wk
type and frequency/duration of physical therapy services for good excellent potential for daily progress toward functional goals and risk losing skills if seen at lower frequency
frequent
5x/wk
type and frequency/duration of physical therapy services for little to no risk of loss of skills d/t presumed length of stay
consult
1-2x/wk
type and frequency/duration of physical therapy services for potential for daily/weekly progress toward functional goals
regular
3-4x/wk
type and frequency/duration of physical therapy services for risk of loss of skills d/t prolonged hospitalization if not followed/progressed by skilled PT
occasional
1-2x/wk
type and frequency/duration of physical therapy services for excellent potential for daily progress towards functional mobility skills, and/or risk losing skills if seen at lower frequency
intense
>/= 6x/wk
type and frequency/duration of physical therapy services for high risk for deconditionng and loss of mobility without direct, skilled PT intervention
frequent/intense
5-6+ x/wk
type and frequency/duration of physical therapy services for need for extensive family ed on newly acquired loss of functional skill
frequent/intense
5-6+ x/wk
type and frequency/duration of physical therapy services for risk of complications associated w immobility and dec physical activity d/t hospitalization, requiring skilled PT to achieve functional goals
regular
3-4x/wk
type and frequency/duration of physical therapy services for dc status doesn’t depend on PT training, intervention, or clearance
regular
3-4x/wk
type and frequency/duration of physical therapy services for dc doesn’t depend on achieving physical therapy goals, but on medical status
frequent
5x/wk
type and frequency/duration of physical therapy services for currently receiving or will most likely be recommended to OP services
regular
3-4x/wk
type and frequency/duration of physical therapy services for dc date depends on PT clearance and/or pt/family trainign
intense
6>/= x/wk
type and frequency/duration of physical therapy services for potential to be recommended for inpatient rehab, day hospital, or high frequency OP services upon dc
frequent/intense
5-6+ x/wk
type and frequency/duration of physical therapy services for dc status doesn’t depend on PT training, intervention, or clearance
consult/occasional
1-2visits total or 1-2x/wk
type and frequency/duration of physical therapy services for possible need for assistance w referral to OP services/clinic to meet long term needs
consult
1-2 visits total
type and frequency/duration of physical therapy services for currently receiving or will most likely be recommended for EI or OP services in community upon dc
occasional
1-2x/wk
what are the 5 main settings for pedi rehab
acute inpatient
day rehab (hospital based)
OP rehab
long-term care
home care
what are 3 reasons that family-centered care is critical
info gathering
info sharing
successful transition to post dc setting
what is the main role of PT in inpatient acute care
safe and effective interventiosn
acute inpatient: rehab needs, frequency, requirements
intensive therapy needs
daily 7x/wk
child unsafe to go home
must need at least 2 services
day rehab (hospital based): rehab needs, frequency, requirements
intensive therapy needs
5x/wk
child safe at home for nights/weekends
needs 2 services
- could be PT and life support
outpatient rehab: frequency and duration, requirements
1-3x/wk
6-12wks per episode of care
defined need for type of service
long term care: rehab needs, frequency, requirements
low intensity need for therapy
1x/wk
family can’t manage care at home
unlikely to regain/gain more function
home care: rehab needs, requirements
low intensity
family able to care for child at home
- child may be “bed bound” but not always
