Pediatrics Team Leader Pediatrics Team members Ericksons Specials Needs Equipment Special mentions Team Members Anesthesia ProvidersSurgeons Nurses Surgical Techs Ancillary Staff ID: 649691
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Pediatrics'
Ethel Maria Kueber, RN CNOR
Pediatrics' Team LeaderSlide2
Pediatrics’
Team members
Erickson’s
Specials Needs
Equipment
Special mentionsSlide3
Team Members:
Anesthesia
Providers/Surgeons
Nurses
Surgical Tech’s
Ancillary StaffSlide4
Pediatric Anesthesia
Dr. Melissa McCall
Dr. Travis Bond
Dr. Steve Sivils
Dr. Leif Lunoe
Dr. Peter Lunoe
Dr. Jan-Ake I. Schultz
Dr. Sara Maurer
Dr. Lindsey CobbSlide5
Providers
Pediatric Surgery
Dr. Brent Roaten
Dr. Stephen Jolley (Retiring June 2013)
Dr. Shawn Safford (Locum-Full Time 6/2014)Slide6
Pediatric Urology
Dr. Dave Bomalaski
Dr. Robert Allen
Dr. Andre GodetSlide7
Neurosurgery
Dr. Estrada Bernard
Dr. Marshall Tolbert
Dr. Susanne FixSlide8
ENT
Dr. Mary Totten
Dr. Stephen Schaffer
Dr. Brent Rosane
Dr. Dwight Ellerbe
Dr. Jerome List
Dr. Christina Magill (ENT/Plastics)
Dr. James KallmanSlide9
Pediatric Dental
Dr. Brant Darby
Dr. Megan Swanzy-Foster
Dr. Caitlin BarnesSlide10
Plastics
Dr. Daniel Suver
Eyes
Dr. Robert Arnold
Slide11
Pediatric Team Leaders
Ethel Maria Kueber, RN CNOR Team Leader
Steve Lopez Surgical Tech Team LeaderSlide12
RN’s
Matthew Reemelin, RN CNOR (scrubs)
Kelsey , RN
Renate’ Wasnuk-Lewis RN (scrubs)
Susan Weaver, RN
Vicie Zielinski, RNSlide13
Scrubs
Stacie Holt, ST
Edgar Johnson, ST
Staff with experience in additional service lines
Linda Ewers, RN Team Lead – ENT, Plastics, Eyes (scrubs)
James Lenichek, RN
Ron Avellaneda, Tech Team Lead – Team Lead for ENT, Plastics, EyesSlide14
Erikson’s Stages of Development
0-2 Trust vs. Mistrust
2-4 Autonomy vs. Shame & Doubt
4-5 Initiative vs. Guilt
5-12 Industry vs. Inferiority
13-19 Identity vs. Role ConfusionSlide15
0-2 Trust vs. Mistrust
Infant very dependent on parents mostly mother
Child’s understanding of the world comes from this relationship
Warmth, regularity and affection – Trust
Unsure environment and lack of basic needs being provided leads to mistrust
Hint’s observe child and parents interactionsSlide16
2-4 Autonomy vs. Doubt
They like to explore the world around them
Start to develop interest: music, animals and play
Increased muscle coordination and mobility
If parents foster antonomy, child will be able to handle more on their own
Use these tools to gain child's trust and cooperation, use Child LifeSlide17
4-5 Initiative vs. Guilt
Child is learning to master basic skills (zip, tie, count and speak with ease)
Likes to complete own actions (may need to allow them extra time)
They may feel guilty over things (they feel guilty about having to have surgery)
Give reassurance this isn’t their faultSlide18
5-12 Industry vs. Inferiority
Become more responsible
Like to get things right
More likely to share and cooperate
Eager to learn
Ask them the questions in conjunction with the parents, most of these kids will be able to tell you what their having doneSlide19
13-19 Identity vs. Role Confusion
Concerned with appearance (these are the kids that you let keep underwear, etc.)
Transition from childhood to adulthood (hint’s-confusion)
The person one has come to be and the person society expects one to becomeSlide20
Anesthesia
Provide support during induction of Anesthesia
Assist with additional IV lines and epidurals
Monitor noise levels during intubation and extubation (laryngospasms)Slide21
Anesthesia Intraoperative
Almost all pediatric codes are due to respiratory origin (80%)
Why
Funneled shaped larynx-narrowest part of the pediatric airway is cricoid cartilage
Larger tongues
Angled Vocal Cords
Take very little to extubate patient/move with caution, always ask before you moveSlide22
Intra op warming devices
K-thermal warming device
Bair hugger
French Fry Lights (know how to use)
Increase Room temp
Don’t let prep fluids poolSlide23
Specials Considerations
Chart
Chart
ChartSlide24
What is normal Slide25
Normal Slide26
Mongolian Spots
Congenital Dermal melanocytosis
Benign, Flat birthmark
Most often seen in Asians, South-East Asians, Polynesians, Naïve American, East Africans and Turkish
Disappears around age 3-5, almost always by pubertySlide27
Mongolian Spot con’tSlide28
Mongolian Spot con’tSlide29
Port Wine Stain
Superficial and deep capillaries in the skin
Reddish to Purplish in color
Present at birth
May be part of a syndrome: Sturge-Weber/Klippel-Trenaunay-Weber Syndrome
Wide range of Tx’s
Slide30
Port Wine Stain’sSlide31
Port Wine Stain con’tSlide32
DELAYS AND SYNDROMES Slide33
DOWNSSlide34
DOWNS SYNDROME
Also known as Trisomy 21
Cased by presence of all or part of a third copy of chromosome 21
Most common chromosome abnormality in humans
Associated with delay in cognitive ability and physical growth
Low IQ’s
Umbilical Hernia
Congenital Heart Disease
Macroglossia
And many moreSlide35
Autism and Asperger’sSlide36
Autism
Neural Development
Characterized by Social Interaction and Communication
Restricted and Repetitive behavior
Sx apparent before age of three
May have birth defects
Prevalence is 1-2 per 1000 people worldwide
CDC reports 20 per 1000 in the United State
Sx start before age two (gradually)
Causes: Strong Genetic BasisSlide37
Asperger
Difficulties in social interactions
Restricted and Repetitive Behaviors
Clumsy
Speech and Language
Cause is unknownSlide38
Usual suspectsSlide39
Even this is included……Slide40
Looking at our future
they will be our caregiversSlide41
Equipment
We need our toolsSlide42
PSOA Laparoscopic CartSlide43
PSOA OPEN CARTSlide44
NICU TO GO CartSpecial thanks to Laura and Dani
Go TeamSlide45
MISC CART (Look this Cart Over)Slide46
Pediatric Cast CartSlide47
SUTURE CARTSlide48
DR. Bomalaski’s Urology CartSlide49
DENTAL CART’SSlide50
Special Needs/Issues
Transporting Pediatric patients
Sedated Patients
Policy on carrying patient
Thanks From the Pediatric Team