Risk Assessment and Early Mobilization Pathway Following Pediatric Tracheostomy: A Pilot Study

Objectives/Hypothesis To confirm the standard of care pertaining to postoperative mobilization practices following initial tracheostomy, to establish face validity of novel early mobilization tools, and to conduct a safety and feasibility pilot study. Study Design Multi‐institutional survey and pros...

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Bibliographic Details
Published in:The Laryngoscope 2021-02, Vol.131 (2), p.E653-E658
Main Authors: Sioshansi, Pedrom C., Byrne, Eilish, Freccero, Allison, Meister, Kara D., Sidell, Douglas R.
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Children & youth
Clinical Protocols - standards
Early Ambulation - adverse effects
Early Ambulation - methods
Early Ambulation - standards
Humans
Laryngoscopy
mobilization
Ostomy
pediatric airway
pediatric health services
Pediatrics
Pilot Projects
Polls & surveys
Prospective Studies
Risk Assessment - methods
Trachea
Tracheostomy - adverse effects
Tracheostomy - rehabilitation
Tracheotomy
Validity
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Summary:Objectives/Hypothesis To confirm the standard of care pertaining to postoperative mobilization practices following initial tracheostomy, to establish face validity of novel early mobilization tools, and to conduct a safety and feasibility pilot study. Study Design Multi‐institutional survey and prospective cohort study. Methods Experts at our tertiary‐care children's hospital developed an Early Pediatric Mobility Pathway for tracheostomy patients utilizing a novel risk‐assessment tool. Surveys were distributed to professional colleagues in similar children's hospitals to establish face validity and incorporate respondent feedback. Additional surveys were disseminated to tertiary‐care children's hospitals across the country to establish the current standard of care, and a pilot study was conducted. Results Seventy‐seven percent of respondents from tertiary hospitals across the country confirmed the standard of care to defer mobilization until the first trach change. Greater than 83% of the respondents used to establish face validity of the tools agreed with the clinical components and scoring structure. The safety and feasibility of early mobilization prior to initial trach change was confirmed with a pilot of 10 pediatric patients without any adverse events. Conclusions Mobilization of pediatric patients prior to initial trach change is feasible and can be safe when risk factors are assessed by a multidisciplinary team. Level of Evidence 4 Laryngoscope, 131:E653–E658, 2021
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.28748