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Jun 14, 2020 by Melissa Khoo,
2 replies
Elaine Horibe Song
MD, PhD, MBA
Hi Melissa

According to the NPIAP, the known PU/PI prevention principles are appropriate for the pediatric population, but the implementation is slightly different for each developmental age. The NPIAP reminds us that providers should not treat children simply as small adults though, as pediatric PIs can be inherently different in etiology. As one of the main causes of PU/PI in the pediatric population is medical devices, special attention is given to preventing medical device related pressure injuries (MDRPI).

For instance, pediatric patients should have a risk assessment using a validated risk assessment instrument for successful PI prevention.

Validated tools for children include:
- Braden Q Scale is a validated, adjusted version for children under 8 years of age. 
- Braden QD scale: revised, simplified version is the "Braden QD Scale", for immobility-related and device-related pressure injuries in the pediatric acute care environment.
- For neonates and children, it's important to ensure that occiput is inspected at least once daily and that skin under and around medical devices is assessed/documented at least twice a day for signs of pressure

These resources provide further details:
- https://woundreference.com/app/topic?id=pressure-ulcersinjuries-prevention#-structured-risk-assessment-
- https://woundreference.com/app/topic?id=pressure-ulcersinjuries#evidence-based-clinical-guidelines (take a look at the free version of the 2014 NPUAP guidelines, section "Special Populations > Pediatric Individuals")
- https://cdn.ymaws.com/npiap.com/resource/resmgr/BestPractices-Pediatric2020.pdf
-https://journals.lww.com/aswcjournal/Fulltext/2019/09000/Pressure_Injuries_in_the_Pediatric_Population__A.5.aspx
Jun 14, 2020
Cathy Milne
APRN, MSN, CWOCN-AP
Hi Melissa,
Great question - as Elaine already replied I did want to add a "must read" on pediatric device related pressure ulcers/injuries.
It is available as a free down load but has a specific chapter devoted to pediatrics.I've attached it here for your convenience.
Take care!
Cathy
Jun 14, 2020
* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.