PEDIATRIC STROKES: The Who, What, When, and Beyond A ... · Because pediatric stroke is as common...
Transcript of PEDIATRIC STROKES: The Who, What, When, and Beyond A ... · Because pediatric stroke is as common...
PEDIATRIC STROKES: The Who, What, When, and Beyond…A Patient and Family Guide
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Tonya Stafford, BSN, RN, CPN* and Gina T. Thompson, BSN, RN, CPNUNC Hospitals Chapel Hill, NC
Introduction:
The prevalence of pediatric strokes, incidence of delay
in treatment & misdiagnosis has become an epidemic in
healthcare. Because pediatric stroke is as common as
brain tumors in children, it is imperative that pediatric
nurses are educated in the basics of this disease
condition. ‘Pediatric Strokes: The Who, What, When
and Beyond is a patient and family guide created by The
Project for Expansion of Education in Pediatric Stroke
(PEEPS). This booklet, the first widely-available
resource of its kind in the United States, is a
comprehensive educational tool for patients and
families.
Objectives:• Learn "Who" can be effected by a stroke, including
types, risk factors, and “What” signs and symptoms
are associated with strokes. Strokes can happen at
any age and should be considered as a differential
when a child presents with neurological symptoms.
• Present a therapy roadmap of "Beyond" in divided
pediatric age groups: infants and toddlers, early
childhood, and teenagers.
• Discuss available resources and common
terminology related to pediatric stroke. This was a
need identified by the families that participated in the
initial PEEPS survey.
2 Types of Strokes:
For more information, please contact: • Tonya Stafford ([email protected])
• Gina Thompson ([email protected])
Methods:• October 2014, PEEPS survey sent to families and
patients affected by strokes.
• Survey included open-ended questions that were
answered by 20 participants. Content for book
was based on needs identified.
BEYOND: A THERAPY ROADMAP…
Physical
Therapy
Speech
Therapy
• Sitting, crawling, walking,
jumping & running
• Strengthening exercises
• Increase movement &
balance (splints & braces)
• Home exercise plan
• Holding a cup, coloring
with a crayon, using a
utensil, using both hands
to grab a toy
• Suck-swallow coordination
• Eating
• Speech development
• Sign language
Physical
Therapy
Rehabilitation is key to help with long term outcome
Speech
Therapy
Occupational
Therapy
• Eating & dressing independently
• Promote self-hygiene: bathing, going to
the bathroom, brushing teeth & hair
PERINATAL
(22 weeks pregnant to
1 month old)
CHILDHOOD
(1 month to
18 years)
TYPES About 80% Ischemic
20% Cerebral Venous Sinus
Thrombosis or Hemorrhage
About 50% Ischemic
50% Hemorrhagic
RISK
FACTORS
• Congenital heart disease
• Placenta disorder
• Clotting disorder
• Infections
• Congenital heart disease
• Disorders of brain vessels
• Infections, head injury
• Sickle cell and
autoimmune disorders
WHAT TO
LOOK
FOR
• Seizures
• Hand preference before
age 1
• Developmental delays
• Hemiparesis
• Sudden numbness or
weakness on 1 side
• Sudden confusion,
difficulty talking or
understanding
• Sudden loss of vision
• Sudden severe headache
• New onset seizures
Stroke Facts• Strokes do not discriminate. They can happen at any age.
• Strokes can happen in infants, toddlers, teenagers and even
in unborn babies. (Actual rate is not known)
• Of children who survive a stroke, about 60% will have
permanent neurologic deficits.
• Boys are more likely to have a stroke than girls.
ISCHEMIC:
Occurs when
a blood
vessel is
blocked.
HEMORRHAGIC:
Occurs when a
blood vessel
bursts within the
brain.
Resources:
Project For The Expansion of Education in Pediatric
Stroke (PEEPS)• www.uncstroke.org/pediatric-stroke
Carolina Acute Stroke Training• Free of charge, available 24/7
• Module #9: Pediatric Stroke
• www.uncstroke.org/CAST
Parent Created Resources• www.bellaflies.org
• www.brendonssmile.org
• www.fightthestroke.org
• www.pediatricstrokewarriors.org
National Resources• The International Alliance for Pediatric Stroke (IAPS)
• The American Stroke Association
• The National Stroke Association
WORDS OF HOPE: Advice from parents & children affected by stroke
• Strengthening exercises
• Increase movement &
balance (splints &
braces)
• Constraint-Induced
Movement Therapy
(CIMT)
• Home exercise plan
Occupational
Therapy
“You are fierce. You’re a survivor. You’re a
fighter through and through. Little brave,
breathe…There’s a mighty warrior within
you. Our children are an inspiration, they
are much more than a diagnosis, and they
will continue to teach us all that differences
can be beautiful and to never
underestimate what they can overcome.”
- Kaysee (Addison’s mom)
“Try not to over-protect your child,
encourage them to try new things.
Let them see what they are
capable of accomplishing.”
- Michelle, age 17
(perinatal stroke survivor)
WHO, WHAT & WHEN:An Overview of Pediatric Stroke
• Swallow study to assess
for problems
• Effective communication
• Memory, recall and
attention
References: National Institutes of Health. (2014). What is a stroke? Retrieved from
http://www.nhlbi.nih.gov/health/healthtopics/stroke
American Heart Association. (2014). Strokes can happen at any age. Retrieved from
http://www.strokeassociation.org/STROKEORG/AboutStroke/StrokeInChildren/What-is-Pediatric-
Stroke-Infographic_UCM_466477_SubHomePage.jsp
International Alliance for Pediatric Stroke. (2014). Insight from the medical professionals. Retrieved
from http://iapediatricstroke.org/doctors_reflections.aspx
Infants & Toddlers
Early
Childhood & Teens