Name of the Procedure:

Common name: Pediatric Tilt-In-Space Wheelchair
Technical term: Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system (HCPCS Code: E1232)

Summary

A pediatric tilt-in-space wheelchair is a specially designed wheelchair for children that allows the seat to tilt while maintaining a fixed angle between the seat and the back. This feature provides pressure relief and helps with postural support. The wheelchair is also adjustable and can be folded for transport.

Purpose

Medical Conditions or Problems Addressed

• Cerebral palsy
• Muscular dystrophy
• Spinal cord injuries
• Severe developmental delays
• Other neurological or musculoskeletal conditions requiring specialized seating

Goals or Expected Outcomes

• Improved postural support and alignment
• Enhanced comfort
• Reduced risk of pressure sores
• Facilitated feeding and respiratory functions

Indications

Specific Symptoms or Conditions

• Difficulty maintaining an upright position
• Increased risk of pressure ulcers
• Need for frequent repositioning throughout the day

Patient Criteria

• Pediatric patients who require complex seating and positioning solutions
• Children who cannot sit independently due to severe physical disabilities

Preparation

Pre-Procedure Instructions

• No fasting or medication adjustments are typically required.

Diagnostic Tests or Assessments

• Physical and functional assessment by a healthcare professional
• Measurement for custom fit and adjustments
• Assessment of the home environment for compatibility with the wheelchair

Procedure Description

Detailed Step-by-Step Explanation

1. Assessment: A physical therapist or occupational therapist evaluates the child's needs and current physical capabilities.
2. Measurement: Precise measurements of the child are taken to ensure a custom fit.
3. Selection: Choose the appropriate wheelchair model and features based on the child's needs.
4. Fitting: The wheelchair is adjusted and fitted to the child.
5. Training: Caregivers and the child are trained on the use and maintenance of the wheelchair.

Tools, Equipment, or Technology Used

• Measuring tools for custom fit
• Adjustable wheelchair with tilting and folding mechanisms
• Various padding and support options

Anesthesia or Sedation Details

• Not applicable

Duration

The initial fitting and training session can take several hours but usually is completed in one day.

Setting

Typically performed in a specialty clinic or rehabilitation center.

Personnel

• Physical Therapist
• Occupational Therapist
• Assistive Technology Professional (ATP)
• Physician (overseeing care plan)

Risks and Complications

Common Risks

• Initial discomfort as the child adjusts to the new seating system
• Minor skin irritations

Rare Risks

• Improper fit causing postural problems or increased risk of pressure sores
• Mechanical failure of the wheelchair components

Possible Complications and Their Management

• Regular follow-ups to ensure proper adjustment and fit
• Immediate correction of any fitting issues

Benefits

Expected Benefits

• Enhanced postural support and comfort
• Improved quality of life and independence
• Reduced risk of pressure sores

Time Frame for Benefits

• Benefits are often realized immediately but may take a few weeks for full adjustment.

Recovery

Post-Procedure Care and Instructions

• Routine checks and adjustments
• Proper skin care and monitoring for pressure sores
• Regular cleaning and maintenance of the wheelchair

Expected Recovery Time

• Ongoing adjustments over weeks to months

Restrictions or Follow-Up Appointments

• Regular follow-up visits for adjustments and maintenance
• Possible yearly reassessment for wheelchair fit and function

Alternatives

Other Treatment Options

• Standard pediatric wheelchairs
• Power wheelchairs with tilt options
• Custom-built seating systems

Pros and Cons of Alternatives

• Standard Pediatric Wheelchairs: Less expensive but may not provide adequate support or comfort.
• Power Wheelchairs: Offer independence for some children but are more expensive and require more maintenance.
• Custom-Built Seating Systems: Provide highly tailored support but at a higher cost and longer manufacturing time.

Patient Experience

What the Patient Might Feel or Experience

• Initial discomfort as they adjust to a new seating system
• Gradual improvements in comfort and posture

Pain Management and Comfort Measures

• Pain is generally not a concern, but discomfort is managed through incremental adjustments to the wheelchair.