Name of the Procedure:

Wheelchair, Pediatric Size, Tilt-in-Space, Rigid, Adjustable, Without Seating System (HCPCS E1233)

Summary

A specialized wheelchair designed for children that offers a tilt-in-space functionality. This feature helps in adjusting the child's posture by changing the orientation of the seat while maintaining a fixed hip angle. The wheelchair is rigid and adjustable but does not include a seating system.

Purpose

The purpose of this pediatric wheelchair is to provide mobility and positioning support for children with certain medical conditions. It helps in enhancing comfort, reducing the risk of pressure sores, and improving sitting tolerance and postural stability.

Indications

This wheelchair is indicated for children who:

• Have limited mobility due to congenital, neuromuscular, or orthopedic disorders.
• Require frequent adjustments in posture to prevent pressure sores.
• Need positioning support to maintain or improve posture.
• Require assistive equipment for better mobility independence.

Preparation

• A thorough seating assessment by a certified healthcare provider specializing in mobility aids.
• Measurement of the child's dimensions to customize the wheelchair.
• Coordination with an occupational or physical therapist to define specific needs.

Procedure Description

1. Assessment: Conducted by a healthcare professional to evaluate the child's needs.
2. Measurement: Detailed measurements of the child’s body to ensure proper fit.
3. Selection: Choosing the appropriate wheelchair model and features based on the assessment.
4. Adjustment: Configuring the wheelchair settings (e.g., tilt angle) to match the child's needs.
5. Fitting: Final fitting and minor adjustments conducted with the child present to ensure comfort and functionality.
6. Training: The child and caregiver receive training on how to use and adjust the wheelchair.

Tools and technology include measuring instruments, adjustment tools provided with the wheelchair, and potentially digital assessment tools. Anesthesia or sedation is not applicable.

Duration

The fitting and adjustment session typically takes about 1-2 hours.

Setting

The procedure is generally performed at a rehabilitation center, clinic, or specialized mobility equipment supplier's facility.

Personnel

• Certified rehabilitation or occupational therapist.
• Certified seating and mobility specialist.
• Caregiver and child.

Risks and Complications

• Improper fitting may cause discomfort or pressure sores.
• Potential for mechanical issues or malfunctions if not correctly maintained.
• Risk of injury if the chair is not used properly.

Benefits

• Enhanced comfort and better postural support for the child.
• Improved mobility and independence.
• Reduced risk of pressure sores and other complications from prolonged sitting.
• Increased interaction and participation in daily activities.

Recovery

There is no recovery time needed for fitting the wheelchair; however, the child and caregivers should follow:

• Regular maintenance of the wheelchair.
• Schedule regular follow-up appointments for adjustments as the child grows or their needs change.

Alternatives

• Standard wheelchairs: May lack necessary tilt and support features.
• Powered wheelchairs: Suitable for children who can control powered mobility devices.
• Custom seating systems: Offer more extensive customization but may be more costly.

Each alternative has its own benefits and limitations based on the child’s specific needs and family resources.

Patient Experience

• The child should feel more comfortable and secure once properly fitted in the wheelchair.
• Initial adjustments may be needed to ensure prolonged comfort.
• Caregivers must be vigilant in monitoring the child's posture and comfort to prevent any issues.

Pain management measures are generally not required, but ensuring the chair's fit and function may significantly improve the child's overall well-being.