TY  - BOOK
AU  - Sterni,Laura M.
AU  - Carroll,John L.
TI  - Caring for the Ventilator Dependent Child: A Clinical Guide
T2  - Respiratory Medicine Series
SN  - 9781493937493
AV  - RC705-779 
U1  - 618.922 
PY  - 2016///
CY  - New York, NY
PB  - Springer New York
KW  - Nursing
KW  - Electronic books
N1  - Intro -- 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 -- 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 -- Chapter 3: Chronic Invasive Mechanical Ventilation -- 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 -- Chapter 4: Ethical Considerations in Chronic Invasive Mechanical Ventilation in Pediatrics -- 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 -- Conclusion; Chapter 5: Palliative Care and End-of-Life Considerations in Children on Chronic Ventilation -- 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 Families -- The Challenges of Palliative Care and Advance Care Planning -- Addressing These Challenges and Talking About End-of-Life Topics -- References -- Chapter 6: Transition from Hospital to Home -- 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 7: The Model of Care for the Ventilator-­Dependent Child -- 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 -- Chapter 8: Outpatient Care of the Ventilator Dependent Child -- 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 -- Chapter 9: In-Home Care of the Child on Chronic Mechanical Ventilation -- 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; Chapter 10: Troubleshooting Common Ventilator and Related Equipment Issues in the Home -- 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 -- Chapter 11: Inhaled Drug Delivery for Children on Long-term Mechanical Ventilation -- Background -- A Brief Primer on Principles of Respiratory Aerosol Delivery -- Delivery Devices -- Patients Receiving Mechanical Ventilation Who Do Not Tolerate Being Disconnected from the Ventilator -- Metered-Dose Inhalers -- Nebulizers -- Patients Receiving Invasive Mechanical Ventilation Who Tolerate Being Disconnected From the Ventilator and Tracheostomized Patients Who Breathe Spontaneously -- Metered-Dose Inhaler -- Nebulizers -- Patient Receiving Noninvasive Mechanical Ventilation Who Do Not Tolerate Being Disconnected from the Ventilator -- Metered-Dose Inhaler -- Nebulizer -- Patients Receiving Noninvasive Mechanical Ventilation Who Tolerate Being Disconnected from the Ventilator -- Clinical Key Points -- Summary -- References -- Chapter 12: Adherence to Non-Invasive Ventilatory Support; 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 -- Chapter 13: Ventilator Support in Children with Obstructive Sleep Apnea Syndrome -- 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 -- Ventilatory Support in Children with OSAS -- 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 -- Efficacy of PAP Ventilation -- Adherence to PAP Ventilation -- Adverse Effects of PAP Ventilation -- Alternative Treatments to PAP Ventilation -- Medications; Treatment with Nasal Insufflation
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