Question about Play

[nescobedo.RN]

Hello Everyone!

I have a question that I was hoping you can help me with. I am an ADN student currently in my pedi rotation and will be assigned to the PICU tomorrow. As part of our preparation we have to create an activity plan that describes how we will stimulate our client. My client is a 10 year old male on a vent with complications of a neurogenic bladder and epilepsy. Can you give me some ideas on what type of play I can provide this client? I have only worked with adults on vents so this will be my first. Any help would be greatly appreciated.

[boomerfriend]

Play for a patient that's vented? I don't think I've ever thought about that one. However, you could put something in his hands (tactile things), do passive range of motion, etc. Our patients are mostly sedated when they're vented so play is not in the picture....at least until they're extubated.

[PICNICRN, BSN, RN]

Like the above post said.... kids who are vented are kept nicely sedated, could even be in a pentobarb coma with the seizures- who knows. I do know that the kid would most likely not be up for play.

How about some music therapy??? Ask the parents what kind of music he likes and get a CD player for him. Maybe that will count??

[kessadawn, BSN, RN]

While I agree that most vented kids are not to be disturbed, we all have seen that "one kid" who is perfectly comfortable and safe while requiring very little if any sedation. They baffle my mind. Perhaps a white board and dry erase markers for communication. The last awake and alert vented kid I had wrote and wrote and wrote on his...he had so much to say! Mostly asking for Captain Crunch and juice, though...

[NotReady4PrimeTime, RN]

My son WAS that kid! I have pictures of him sitting up in bed, ETT hanging out of his mouth, listening intently to me reading to him.

My experience is that most kids who need mechanical ventilation are not that cooperative though. Some are so difficult to manage that they have to be pharmacologically paralyzed, which requires so much sedation that they're completely unaware.

[rachelgeorgina]

I haven't worked with vented patients (I'm still a student) but I work as an NA with profoundly disabled children (I'm talking very limited ROM, no speech, significant developmental delay, wheelchair bound etc) and sometimes it's really hard to stimulate these kids. Often touch - either in the soothing sense ---> holding their hands, tickling, cuddles etc, in combination with talking with them animatedly or playing stimulating/relaxing music (depending on the goal) or in a more stimulatory sense ---> we have a two-year-old that the OT made a "tactile book" for. She is learning to turn the pages of this oversized book in order to touch the different things on each page, which stimulate her sense of touch.