The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

RESPIRATORY CARE DEVICE SELECTION WITH THE CARE OF MEDICALLY FRAGILE CHILDREN

Lindsay B. Miller1, Teresa A. Volsko1



Background: Medically fragile children have a variety of conditions that affect their cardiopulmonary health status. Many of these children have medical conditions, profound mental and motor retardation of multifactorial etiologies which will affect the accuracy of values obtained from non-invasive monitoring devices as well as the ability to clear airway secretions. As a member of the healthcare team, the respiratory therapist must be able to recognize those conditions that will interfere with or affect the therapeutic outcome. We sought to determine if therapists knowledge of the conditions that affect the respiratory care of medically fragile children influence their practice patterns. We hypothesize that knowledge deficits regarding the etiologies that affect oxygen saturation readings or selection of airway clearance technique affect the practice of respiratory care administered to this population.

Methods:
A 10 question survey gathered information regarding knowledge of medical conditions that may affect the use of airway clearance devices and non-invasive monitoring techniques for oxygen saturation in this special population. The tool was mailed to a convenience sample of respiratory therapists from three tertiary care pediatric hospitals in northeastern Ohio. Data were entered into SPSS 15.0 (Chicago, IL) for analysis. Descriptive statistics are reported. Results: Nine of 50 surveys were returned yielding an 18% response rate. Greater than 89% of therapists surveyed were able to recognize that seizures, cerebral palsy, chest wall deformities, gastro-esophageal reflex, obstructive apnea and behavior issues affect the respiratory care rendered to this population. However, 67% failed to recognize temperature regulation as a significant problem. Only 66% identified the correct position to drain the anterior segment of the right upper lobe in a patient with reflux disease. All participants acknowledged that finger probe placement was the most commonly used site to obtain non-invasive oxygen saturation readings. However, 11.1% correctly identified that this was not the most appropriate site to obtain accurate readings.

Conclusions:
Respiratory care administered to medically fragile children may be affected by practitioner knowledge deficits of technology, services and support needed for the survival of this special population.