RT Book, Section
A1 Feinstein, James A.
A1 Brittan, Mark
A1 Stille, Christopher J.
A2 Kline, Mark W.
SR Print(0)
ID 1182927590
T1 Managing Technology in Children with Medical Complexity
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182927590
RD 2024/04/23
AB In  1987,  the  former  US  Office  of  Technology  Assistance  defined  the  medically  fragile,  technology-dependent  child  as  “one  who  needs  both  a  medical  device  to  compensate  for  the  loss  of  a  vital  body  function  and  substantial  ongoing  nursing  care  to  avert  death  or  further  disability.”  The  continued  growth  of  medical  knowledge  and  technology  over  the  years  has  led  to  an  increase  in  the  number  of  children  with  medical  complexity  (CMC)  who,  through  the  use  of  technological  assistance,  live  longer  and  at  home,  yet  still  have  frequent  hospital  admissions.  While  no  newer  standard  definition  of  medical  complexity  and  fragility  has  been  established,  a  number  of  definitions  exist  with  the  most  common  unifying  theme  being  a  reliance  on  medical  technology  devices,  such  as  the  use  of  a  tracheostomy,  mechanical  ventilation,  an  enteral  feeding  tube,  or  a  vascular  access  device.  Some  have  incorporated  the  use  of  assistive  devices  associated  with  communication  or  mobility  impairments  into  the  definition  of  technology  assistance.  In  this  chapter,  we  will  review  select  technology  devices  and  supports,  examine  the  role  of  specialized  therapists  to  address  functionality,  and  discuss  assistive  devices  and  home  modifications  needed  to  improve  the  child’s  mobility,  transportation,  and  activities  of  daily  living.  Educational  and  communication  devices  are  beyond  the  scope  of  this  chapter  due  to  their  complexity  and  rapid  change  (see  Chapter  89).