Deciding on and Preparing for Major Musculoskeletal Surgery in Children with Medical Complexity
The course’s current focus is preoperative care for major hip and spine surgeries. The course is currently tailored the most to children with cerebral palsy and other neurodevelopmental disorders. Chronic musculoskeletal problems are prevalent in these children. The approach to pre-operative care conveyed in the guide generalizes to children with complex chronic conditions, especially those with multimorbidity and assistance with indwelling medical devices. There are four major content sections in the course: Overview, Getting Started, Assessing Pre-Op Health (Parts I and II) and Acting on Health Assessment.
Learning Objectives
Demonstrate knowledge of evidence and process to prepare children with medical complexity for major musculoskeletal surgery
Perform a pre-operative comprehensive health assessment, identify risk factors that may impede perioperative safety, and address the risk factors
Practice shared decision making to best support patients and families when deciding whether to pursue surgery
Assemble proactive care plans and arrange communications and hand-offs to intra- and post-operative providers to ensure the safest perioperative transit possible
Lessons
Deciding on and Preparing for Major Musculoskeletal Surgery In Children with Medical Complexity
Author(s)
Mirna Giordano, MD
Assistant Professor of Pediatrics | Columbia University Medical Center
Robert Graham, MD
Senior Associate in Critical Care Medicine, Department of Anesthesiology
Critical Care and Pain Medicine | Boston Children's Hospital
Associate Professor of Anaesthesia | Harvard Medical School
David Casavant, MD
Senior Associate in Critical Care Medicine, Department of Anesthesiology
Critical Care and Pain Medicine | Boston Children's Hospital
Assistant Professor of Anaesthesia | Harvard Medical School
Mohan Belthur, MD
Clinical Assistant Professor, Department of Child Health | University of Arizona College of Medicine - Phoenix
Sara Quates, APNP, MSN
Pediatric Nurse Practitioner | Children's Wisconsin - Milwaukee
Juan Carlos Flores, MD
Chief of Anesthesiology Department, Director of the University Residency of Anesthesiology | Buenos Aires University (UBA) School of Medicine University
Chantel Barney, Ph.D
Clinical Scientist | Gillette Children's Hospital
Lucia Bastianelli, RN, MSN, CPNP
Pediatric Nurse Practitioner, Cerebral Palsy and Spasticity Center | Boston Children's Hospital
Kathy Harney, RN, CPNP
Pediatric Nurse Practitioner, Critical Care | Boston Children's Hospital
Anesthesia Perioperative and Home Ventilation (CAPE Program) | Boston Children's Hospital
Elisabeth Pordes, MD, MPH
Assistant Professor, Pediatrics | Children’s Hospital of Wisconsin
Pediatrician, Complex Care/Special Needs Program | Children Hospital of Wisconsin/Medical College of Wisconsin
Neonatal Intensive Care Unit Hospitalist | The Monroe Carrell Jr Children’s Hospital at Vanderbilt
Charis Crofton, BS
Medical Student | Rush Medical College
Brigid Garrity, BS
Graduate Research Assistant, Department of Health Law, Policy and Management | Boston University School of Public Health
Elizabeth Casto, MPH
Quality Improvement Consultant, Department of Cardiology | Boston Children’s Hospital
Jay G. Berry, MD, MPH
Chief, Complex Care Services | Boston Children's Hospital
Associate Professor | Harvard Medical School
Gina Rempel, MD, FRCPC, FASPEN
Medical Lead | Children's Hospital Winnipeg/ University of Manitoba
Pediatric Provincial Enteral Nutrition Support | Children's Hospital Winnipeg/ University of Manitoba
Pediatric Rehabilitation and Complex Care | Children's Hospital Winnipeg/ University of Manitoba
Course Director(s)
Jay G. Berry, MD, MPH
Chief, Complex Care Services | Boston Children's Hospital
Associate Professor | Harvard Medical School
Gina Rempel, MD, FRCPC, FASPEN
Medical Lead | Children's Hospital Winnipeg/ University of Manitoba
Pediatric Provincial Enteral Nutrition Support | Children's Hospital Winnipeg/ University of Manitoba
Pediatric Rehabilitation and Complex Care | Children's Hospital Winnipeg/ University of Manitoba
Citation
Berry JG, Giordano M, Graham R, Casavant D, Belthur M, Quates S, Flores JC, Barney C, Bastianelli L, Harney K, Pordes E, Crofton C, Garrity B, Casto E, Rempel G. Deciding on and Preparing for Major Musculoskeletal Surgery in Children with Medical Complexity. 12/2020. Online Module. OPENPediatrics. https://learn.openpediatrics.org/learn/course/internal/view/elearning/4840/deciding-on-and-preparing-for-major-musculoskeletal-surgery-in-children-with-medical-complexity.