Presentation8.pptx

Test 2: NICU & Hospital Megan Geary Neonatal overstimulation Visual system of an infant is incomplete before birth o Super vulnerable to intrusive lighting o Underdeveloped iris to constrict and block the light Noise levels should be maintained o Blankets, silencers, voice levels...

Test 2: NICU & Hospital Megan Geary Neonatal overstimulation Visual system of an infant is incomplete before birth o Super vulnerable to intrusive lighting o Underdeveloped iris to constrict and block the light Noise levels should be maintained o Blankets, silencers, voice levels o Loud sounds add stress o NICU workers are desensitized to these sounds More on the sensory environment Importance of sensory environment: Caregiver interactions (animate), bed, temperature, humidity, odors, lighting, sound levels (physical or inanimate) Type of sensory stimuli and the amount of exposure The conditions under which intervention is being implemented The timing of intervention in regards to infants gestational age and ability to process What is the OT's role? Evaluating - is always ongoing, observation is key, modification of assessments, work collaboratively Interventions: Minimizing avoidable stress Prevention of fragile skin & cold stress Supportive touch & handling Avoidance of intrusive light & sound Caregiver education Positioning & NDT Breast & bottle feeding Sucking - nutritive vs nonnutritive Risks of being preterm Lung underdevelopment Cardiopulmonary issues IVH - increase likelihood of CP, developmental disorders/motor impairments Increased risk of learning difficulties Necrotizing enterocolitis Retinopathy of prematurity o Potential detachment & blindness Low birth weight babies Birthweight is a significant factor in survival & outcome BW of 1500-2000g is termed low birth weight BW of 1000-1500 is termed very low birth weight BW less than 1000 is termed extremely low birth rate BW less than 750g is termed incredibly low birthweight or "Micropremies" Immature lung development & require immediate positive pressure support after birth o Oscillatory ventilation o Conventional mechanical ventilation o CPAP Table 26.1 Limited ROM o Reachers, shoe horns, switch operated, enlarged or different style handles Decreases strength/endurance o Lighter weight objects, electrically powered, extended handles, mounting devices Incoordination o Achieve proximal stability, consider requirements of task, One handed techniques o Specifically designed tools or methods, lots of training Perceptual & cognitive limitations o Step by step routines, work simplification, memorizing & reciting verbal routine, tactile feedback cues Visual impairment o Environment mods, tactile feedback, sound feedback, long canes/guide dogs OT's in Hospitals - What do they do? OT's working in hospitals initially focus on lifesaving and sustaining procedures Preventing unnecessary complications o By means of splinting, positioning, evaluating oral motor skills for feeding ADL training Age-appropriate participation in play Acute ICU acute care o The child is evaluated and treated bedside due to critical nature of illness or injury and the need for constant monitoring of the child's physiological status General acute care: o For a child who is now more medically stable and interacting with environment o Focus on promotion of homeostasis and prevention of secondary complications of immobility Intervention priorities Maintaining skin integrity Paying attention to: o vitals & monitors o Pain management o Pharmacologicals Coping mechanisms Trunk & postural control Prevention of clotting & DVT Pediatric Rehab Such as a SNF Children are too medically fragile or dependent to be cared for at home, and not yet able to engage in acute level care Acute rehab o Organize & implement a planned approach for the management of recovery and rehabilitation of children post trauma or with rapid onset disorders o Redirect care after onset complications in children with chronic disorders o Provide an environment for specialized medical or surgical procedures that involves specific care regiments & protocols Outpatient Organized to provide monitoring and interventions, as well as follow up and follow along attention post hospitalization Focus on health status & development, emphasizing functional progress & participation in home, school and community activities Outpatient is often provided for three reasons: o As part of diagnostic assessment o To provide needed intervention & assistive technology after hospital discharge o Provide occupational therapy intervention for individuals with disabilities or other medical conditions not requiring hospitalization