of Medicine and Health Sciences Washington, DC, USA
Peter J. Madsen, MD Division of Neurosurgery Children’s Hospital of Philadelphia Philadelphia, PA, USA and Department of Neurosurgery Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA, USA
Meg Ann Maguire, MS, RN, CRNP, CPNP-PC Division of Plastic and Reconstructive Surgery Children’s Hospital of Philadelphia Philadelphia, PA, USA
Peter Mattei, MD Division of General, Thoracic and Fetal Surgery Children’s Hospital of Philadelphia Philadelphia, PA USA and Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
Oscar H. Mayer, MD Division of Pulmonary and Sleep Medicine Children’s Hospital of Philadelphia Philadelphia, PA USA and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
Xenia Morgan, CRNP Hemodialysis Unit Division of Nephrology Children’s Hospital of Philadelphia Philadelphia, PA USA
Chariton Moschopoulos, MD Division of Neurology Boston Children’s Hospital Harvard Medical School Boston, MA USA
Anthony Mozzone, BA, CRT Promptcare Respiratory King of Prussia, PA USA
Natalie Napolitano, MPH, RRT, RRT-NPS, FAARC Department of Respiratory Care Services Children’s Hospital of Philadelphia Philadelphia, PA USA
Courtney E. Nelson, MD Division of Emergency Medicine Department of Pediatrics AI DuPont Hospital for Children Wilmington, DE, USA and Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia, PA, USA
Susan E. Nelson, MD, MPH Department of Orthopedic Surgery University of Rochester Medical Center Rochester, NY USA
Phuong D. Nguyen, MD Division of Plastic and Reconstructive Surgery Children’s Hospital of Philadelphia Philadelphia, PA USA
Amanda J. Nickel, MSc, RRT-NPS, RRT-ACCS Department of Respiratory Care Services Children’s Hospital of Philadelphia Philadelphia, PA USA
Chima Oluigbo, MD Department of Neurosurgery Children’s National Hospital Washington, DC, USA and George Washington University School of Medicine and Health Sciences Washington, DC, USA
Michael J. O’Neal, MD Department of Emergency Medicine University of San Francisco San Francisco, CA USA
Michael Phillips, MD Department of Urology George Washington University School of Medicine and Health Sciences Washington, DC USA
Pelton A. Phinizy, MD Division of Pulmonary and Sleep Medicine Children’s Hospital of Philadelphia Philadelphia, PA USA and Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
Desiree M. Seeyave, MB.BS Department of Emergency Medicine & Hospitalist Services Children’s Hospital of Georgia Emergency Department Augusta, GA USA
Sameer Shakir, MD Division of Plastic Surgery Children’s Hospital of Philadelphia Philadelphia, PA USA
Joanne Stow, MSN, APRN, PPCNP-BC, CORLN Division of Otolaryngology Department of Surgery Children’s Hospital of Philadelphia Philadelphia, PA, USA
Ellen G. Szydlowski, MD Division of Emergency Medicine Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia, PA USA and Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
John F. Tamasitis, RRT-NPS Children’s Hospital Home Care Children’s Hospital of Philadelphia King of Prussia, PA USA
Andrew Tyler, MD, PhD Department of Orthopedic Surgery Vanderbilt University Medical Center Nashville, TN USA
R. Jason VonDerHaar, MD Department of Surgery Indiana University Health Indianapolis, IN USA and University of Indiana School of Medicine Indianapolis, IN USA
Katie Wagner, BS George Washington University School of Medicine and Health Sciences Washington, DC USA
Carmelle Wallace, MD, MPH Division of Emergency Medicine Department of Pediatrics University of Alabama at Birmingham Birmingham, AL USA
Anna Weiss, MD, MSEd Division of Emergency Medicine Department of Pediatrics Children’s Hospital of Philadelphia Philadelphia, PA USA and Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
Kimberly Windt, MSN, RN, CNN Hemodialysis Unit Division of Nephrology Children’s Hospital of Philadelphia Philadelphia, PA USA
Liza C. Wu, MD Department of Surgery Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia Philadelphia, PA, USA and Division of Plastic Surgery Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA
David Yamane, MD Department of Emergency Medicine George Washington University Hospital and Department of Anesthesia and Critical Care Medicine George Washington University Hospital Washington, DC USA
Preface
The idea of writing this book was born in early 2016; we knew that the road would be bumpy yet exciting! We are thrilled to introduce the first edition of our manual to assist health care providers in managing our very unique patients with various hardware devices. These “hi‐tech” devices help our patients breathe, walk, hear, and do a host of other essential activities of daily living. Importantly, when these patients seek emergency care due to device malfunction, infections, or other complications, it is crucial that the medical provider know how to manage both the patient and the device.
It is often challenging for the emergency/critical care clinician to troubleshoot and, sometimes, even identify the problems with many of these hi‐tech devices. Moreover, specialized consultation is not always readily available. It is quite challenging for providers to recall complex diagnostic and therapeutic algorithms for patients with specialized equipment, thus increasing the risk for morbidity and mortality. This guide provides a stepwise approach to acute presentations of patients with clinical hardware, focusing on specific instructions for initial evaluation and management. Our intent is that this endeavor will assist health care providers in both community settings and academic centers in the treatment of complex patients with “hi‐tech” equipment.
It is our sincere hope that this book will improve the quality of care to our unique patient population who utilize specialized hardware. Our goal is to provide our readers with an overview of the basic approach to clinical scenarios of device malfunction and related complications of the most commonly used medical devices. However, as it was impossible to include all devices in this book, the practitioner should make every effort to ensure they have the most accurate information for each patient's hardware.
We want to thank our fellow editors, authors, and contributors, who gave their time selflessly so that we could produce this book. Also, we would like to thank our teachers, mentors, and colleagues, from whom we learn every day. Most importantly, the real source of our inspiration, our patients and their families, deserve our eternal heartfelt gratitude.
Ioannis and Nick
Acknowledgments
I would like to thank Nick and all the editors of the book, as, without them, this effort would not have been possible. Nick’s support was really amazing, and his help with some of the problems we faced during the creation of