Emergency Management of the Hi-Tech Patient in Acute and Critical Care

Sarah Fesnak, MDDivision 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

James B. Fink, PhD, RRT, FAARC, FCCPAerogen Pharma Corporation San Mateo, CA, USA and Rush Medical School Chicago, IL USA and Texas State University Round Rock, TX USA

Tenagne Haile‐Mariam, MDDepartment of Emergency Medicine George Washington University School of Medicine and Health Sciences Washington, DC USA

Heather House, MDDivision 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

Massoud Kazzi, MDDepartment of Emergency Medicine George Washington University School of Medicine and Health Sciences Washington, DC USA and Critical Care Medicine Washington Adventist Hospital Takoma Park, MD USA

Benjamin C. Kennedy, MDDepartment of Neurosurgery Perelman School of Medicine at the University of Pennsylvania Philadelphia, PA USA and Division of Neurosurgery Children’s Hospital of Philadelphia Philadelphia, PA USA

Panagiotis Kratimenos, MD, PhDDivision of Neonatal-Perinatal Medicine Children’s National Hospital Washington, DC, USA and George Washington University School of Medicine and Health Sciences Washington, DC, USA

Megan Lavoie , MD, FAAPDivision 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

Jamie Lovell, MDDivision of Emergency Medicine Department of Pediatrics Cincinnati Children’s Hospital Medical Center Cincinnati, OH USA and University of Cincinnati College of Medicine Cincinnati, OH USA

William P. Madigan, MDDivision of Ophthalmology Children’s National Hospital Washington, DC, USA and Uniformed Services University of the Health Sciences Bethesda, MD, USA and George Washington University School of Medicine and Health Sciences Washington, DC, USA

Peter J. Madsen, MDDivision 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-PCDivision of Plastic and Reconstructive Surgery Children’s Hospital of Philadelphia Philadelphia, PA, USA

Peter Mattei, MDDivision 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, MDDivision 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, CRNPHemodialysis Unit Division of Nephrology Children’s Hospital of Philadelphia Philadelphia, PA USA

Chariton Moschopoulos, MDDivision of Neurology Boston Children’s Hospital Harvard Medical School Boston, MA USA

Anthony Mozzone, BA, CRTPromptcare Respiratory King of Prussia, PA USA

Natalie Napolitano, MPH, RRT, RRT- NPS, FAARCDepartment of Respiratory Care Services Children’s Hospital of Philadelphia Philadelphia, PA USA

Courtney E. Nelson, MDDivision 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, MPHDepartment of Orthopedic Surgery University of Rochester Medical Center Rochester, NY USA

Phuong D. Nguyen, MDDivision of Plastic and Reconstructive Surgery Children’s Hospital of Philadelphia Philadelphia, PA USA

Amanda J. Nickel, MSc, RRT-NPS, RRT-ACCSDepartment of Respiratory Care Services Children’s Hospital of Philadelphia Philadelphia, PA USA

Chima Oluigbo, MDDepartment 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, MDDepartment of Emergency Medicine University of San Francisco San Francisco, CA USA

Michael Phillips, MDDepartment of Urology George Washington University School of Medicine and Health Sciences Washington, DC USA

Pelton A. Phinizy, MDDivision 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.BSDepartment of Emergency Medicine & Hospitalist Services Children’s Hospital of Georgia Emergency Department Augusta, GA USA

Sameer Shakir, MDDivision of Plastic Surgery Children’s Hospital of Philadelphia Philadelphia, PA USA

Joanne Stow, MSN, APRN, PPCNP-BC, CORLNDivision of Otolaryngology Department of Surgery Children’s Hospital of Philadelphia Philadelphia, PA, USA

Ellen G. Szydlowski, MDDivision 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-NPSChildren’s Hospital Home Care Children’s Hospital of Philadelphia King of Prussia, PA USA

Andrew Tyler, MD, PhDDepartment of Orthopedic Surgery Vanderbilt University Medical Center Nashville, TN USA

R. Jason VonDerHaar, MDDepartment of Surgery Indiana University Health Indianapolis, IN USA and University of Indiana School of Medicine Indianapolis, IN USA

Katie Wagner, BSGeorge Washington University School of Medicine and Health Sciences Washington, DC USA

Carmelle Wallace, MD, MPHDivision of Emergency Medicine Department of Pediatrics University of Alabama at Birmingham Birmingham, AL USA

Anna Weiss, MD, MSEdDivision 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, CNNHemodialysis Unit Division of Nephrology Children’s Hospital of Philadelphia Philadelphia, PA USA

Liza C. Wu, MDDepartment 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, MDDepartment of Emergency Medicine George Washington University Hospital and Department of Anesthesia and Critical Care Medicine George Washington University Hospital Washington, DC USA

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.