Posts Tagged medically fragile

What Defines a child that is Medically Fragile?

Posted by on Tuesday, 13 April, 2010

“Medically Fragile or Special Health Care Needs Dependent”

To be defined as a special needs child, children must have special health care needs meaning the child must have a the need for specialized in-home health care based upon one or more of the following criteria:

  • Enteral Feeding Tube (nutrition fed through a tube placed in the nose, the stomach, or the small intestine.)
  • (TPN Dendent) Total Parenteral Feeding (supplies all the nutritional needs of the body by bypassing the digestive system, dripping nutrient solution directly into a vein.)
  • Cardiorespiratory Monitoring
  • Intravenous Therapy
  • Ventilator dependent
  • Oxygen Support
  • Urinary Catherization
  • Renal Dialysis
  • Ministrations imposed by tracheotomy, colostomy, Ileostomey, or other medical, surgical procedures.

Also, any condition that can rapidly deteriorate resulting in permanent injury or death. These children are commonly referred to as “medically fragile.” Typically, medically fragile children are infants under 3 years of age who are prone to hospitalization.

The following are a few examples of conditions that often, but certainly not always, qualify a child as medically fragile.

  • Prenatal exposure to drugs and/or alcohol
  • Congenital or hereditary defects such as spina bifida, sickle cell, anemia, cystic fibrosis, netherton syndrome, heart , lung defects.
  • Burns
  • Cerebral Palsy
  • Muscular Dystrophy
  • Epilepsy
  • BPD – Bronchopulmonary dysplasia
  • Failure to thrive
  • HIV positive and symptomatic
  • Permaturity

With the on going advances in medicine, the quality of life and longevity has vastly improved for medically fragile children. Many medically fragile children are able to be cared for in “specialized licensed foster care homes” with mandated individualized care plans outlining the child’s medical care needs as opposed to having to stay in hospital ward. This home setting has proven to to facilitate improvements in the child’s condition and well being.

Helpful Interventions

Posted by on Saturday, 3 April, 2010

Interventions to decrease stress in the drug exposed medically fragile infant

  • Decrease lights and noise in room, including TV/radio.
  • Wrap the baby snugly with hands mid-line.  This helps to overcome extensor tone.
  • Always place baby on back or side to sleep—never on tummy.
  • Hold the baby’s hands mid-line over the baby’s chest with one of your hands, exerting a secure feeling.
  • Try rocking with baby held vertically. This is often more successful than horizontal rocking.
  • Frequent warm water baths help calm them.
  • If baby is gaze averting seemingly over stimulated by simple eye contact with you, sit the baby on your lap, snugly wrapped, facing away from you.
  • Do not use walkers with these infants. Walkers increase predisposition to weight bear on toes.
  • Protect the baby’s knees from irritation during periods of frantic fussiness.
  • Use a pacifier to help with their non-nutritive sucking needs.