1. Ethel Maria Kueber, RN CNOR Pediatrics' Team Leader

2. Pediatrics’ Team members Erickson’s Specials Needs Equipment
Special mentions

3. Team Members: Anesthesia Providers/Surgeons Nurses Surgical Tech’s
Ancillary Staff

4. 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 Cobb

5. Providers
Pediatric Surgery Dr. Brent Roaten Dr. Stephen Jolley (Retiring June 2013) Dr. Shawn Safford (Locum-Full Time 6/2014)

6. Pediatric Urology
Dr. Dave Bomalaski
Dr. Robert Allen
Dr. Andre Godet

7. Neurosurgery
Dr. Estrada Bernard
Dr. Marshall Tolbert
Dr. Susanne Fix

8. ENT Dr. Mary Totten Dr. Stephen Schaffer Dr. Brent Rosane
Dr. Dwight Ellerbe
Dr. Jerome List
Dr. Christina Magill (ENT/Plastics)
Dr. James Kallman

9. Pediatric Dental Dr. Brant Darby Dr. Megan Swanzy-Foster
Dr. Caitlin Barnes

10. Plastics
Dr. Daniel Suver
Eyes
Dr. Robert Arnold

11. Pediatric Team Leaders
Ethel Maria Kueber, RN CNOR Team Leader
Steve Lopez Surgical Tech Team Leader

12. RN’s Matthew Reemelin, RN CNOR (scrubs) Kelsey , RN
Renate’ Wasnuk-Lewis RN (scrubs)
Susan Weaver, RN
Vicie Zielinski, RN

13. 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, Eyes

14. Erikson’s Stages of Development
Trust vs. Mistrust
Autonomy vs. Shame & Doubt
Initiative vs. Guilt
Industry vs. Inferiority
Identity vs. Role Confusion

15. 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 interactions

16. 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 Life

17. 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 fault

18. 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 done

19. 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 become

20. Anesthesia Provide support during induction of Anesthesia
Assist with additional IV lines and epidurals
Monitor noise levels during intubation and extubation (laryngospasms)

21. 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 move

22. 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 pool

23. Specials Considerations
Chart

24. What is normal

25. Normal

26. 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 puberty

27. Mongolian Spot con’t

28. Mongolian Spot con’t

29. 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

30. Port Wine Stain’s

31. Port Wine Stain con’t

32. DELAYS AND SYNDROMES

33. DOWNS

34. 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 more

35. Autism and Asperger’s

36. 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 Basis

37. Asperger Difficulties in social interactions
Restricted and Repetitive Behaviors
Clumsy
Speech and Language
Cause is unknown

38. Usual suspects

39. Even this is included……

40. Looking at our future they will be our caregivers

41. Equipment
We need our tools

42. PSOA Laparoscopic Cart

43. PSOA OPEN CART

44. NICU TO GO Cart Special thanks to Laura and Dani Go Team

45. MISC CART (Look this Cart Over)

46. Pediatric Cast Cart

47. SUTURE CART

48. DR. Bomalaski’s Urology Cart

49. DENTAL CART’S

50. Special Needs/Issues Transporting Pediatric patients Sedated Patients
Policy on carrying patient
Thanks From the Pediatric Team