Some technology dependent patients may require an inpatient stay for care of an acute illness or further evaluation. Patients with artificial airways (tracheostomies) are generally admitted to the Neonatal Infant Center (NIC), Pediatric Intensive Care Unit (PICU), or the long term ventilator unit (Progressive Care Unit, PCU), depending on the age of the child and acuity of the condition. Patients requiring non-invasive ventilation who are medically stable may be admitted to other units.
During the inpatient stay, the child will be followed by the pulmonary consultation service which includes a board-certified attending pediatric pulmonologist and a pediatric pulmonary fellow. This team works in close collaboration with the primary services in the intensive care settings. Other Technology Dependence Center staff, including the advanced practice nurses, nutritionist and social workers become involved as they are needed.
Patients followed in the Technology Dependence Center are seen in the outpatient office on the 5th floor of the Richard D. Wood Ambulatory Building on The Children's Hospital of Philadelphia's main campus.
Patients are typically seen quarterly, but more frequent follow-up may be necessary depending on the child's condition. Outpatient evaluations include a comprehensive history and physical examination, assessment of growth, measurements of oxygenation and ventilation, and when possible, other measurements of lung function. These visits are multi-disciplinary in that they involve one of the attending pulmonary physicians, an advanced practice nurse, a nutritionist and social worker, all specialized in the care of children requiring extra technology to breathe. A record of each outpatient visit is sent to the child's primary care physician. Patients may be referred to the Pulmonary Function Laboratory for measurement of lung function, instruction in assisted airway clearance techniques or aerosol treatments.
While patients are cared for at home by parents and/or nurses, our staff remains available for telephone consultations. Children undergoing weaning from mechanical ventilation are usually evaluated weekly via telephone contact between our advanced practice nurses and the caretakers. This allows for careful attention to growth and respiratory status during this process without requiring office visits for each change.