Risk Assessment and Early Mobilization Pathway Following Pediatric Tracheostomy: A Pilot Study

Area of Science:

• Pediatric Critical Care
• Respiratory Therapy
• Rehabilitation Medicine

Background:

• Postoperative mobilization practices for pediatric tracheostomy patients vary.
• Current standard of care often defers mobilization until after the initial tracheostomy change.
• Novel tools for early mobilization require validation.

Purpose of the Study:

• To confirm the standard of care for postoperative mobilization in pediatric tracheostomy patients.
• To establish face validity of new early mobilization tools.
• To conduct a pilot study on the safety and feasibility of early mobilization.

Main Methods:

• Multi-institutional survey to determine the standard of care.
• Survey distributed to establish face validity of novel risk-assessment and mobility tools.
• Prospective pilot cohort study of pediatric patients undergoing tracheostomy.

Main Results:

• 77% of surveyed hospitals defer mobilization until the first tracheostomy change.
• Over 83% of respondents validated the clinical components and scoring of the new tools.
• Pilot study of 10 pediatric patients showed early mobilization was safe and feasible without adverse events.

Conclusions:

• Early mobilization of pediatric tracheostomy patients before the initial tracheostomy change is feasible.
• Mobilization can be safely implemented when risk factors are assessed by a multidisciplinary team.