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Osteogenesis Imperfecta. Caring for school aged children in a community program. Osteogenesis Imperfecta. Brittle bone disease Genetic disorder Characterized by fragile bones that break easily Other health issues frequently seen in children with OI Short stature
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OsteogenesisImperfecta Caring for school aged children in a community program 2016-07-15
OsteogenesisImperfecta • Brittle bone disease • Genetic disorder • Characterized by fragile bones that break easily • Other health issues frequently seen in children with OI • Short stature • Weak tissues, fragile skin, muscle weakness, and loose joints • Bleeding, easy bruising, frequent nosebleeds • Brittle teeth • Hearing loss • Vision problems • Breathing problems • Curvature of the spine
Types of OI • 8 types • OI types range from a mild form with no deformity, normal stature and few fractures to a form that is lethal prior to and after birth • Medical problems a person will depend on the type of OI
Treatment Goals • Minimize fractures • Maximize independent function • Promote general health Treatments • Physical therapy and safe exercise • Casts, splints or wraps for broken bones; • Braces to support legs, ankles, knees and wrists as needed • Orthopedic surgery • Medications to strengthen bones • Mobility aids
SAFETY PRECAUTIONSPhysical environment Common barriers • Stairs • Restrooms with narrow or heavy doors • High sinks, stalls too narrow for a wheelchair • Play structures with stairs • Inaccessible hands-on work areas Possible strategies • portable ramps, wheelchair lifts • lowering equipment • providing a low desk or work surface • providing the child with adult assistance in the restroom if required
SAFETY PRECAUTIONSClassroom/hallway Possible strategies • Allow child to leave class several minutes early • In multi-level school buildings, allow child to use elevator • Allow the child to select a seat that is easy to get to • Provide an extra set of books
SAFETY PRECAUTIONSPhysical Education Efforts should be made to involve the child with OI in the same activities as other students with appropriate modifications • Child may be restricted from playing contact sports • Avoid activities that jar or twist the spine • Wearing a helmet and knee/elbow pads for some sports (e.g. bike riding) is recommended • Good fitting shoes help to support the ankles, and prevent tripping/slipping • If you are not certain if a child with OI should participate discuss it with the parent/guardian
SAFETY PRECAUTIONSRecess/playground • May be able to use traditional playground equipment • May require or benefit from accessible playground equipment • Remind all children that safe and considerate play is important for preventing injury. Fire Evacuation • May require the use of a wheelchair or other mobility devices • Establish and practice a child-specific fire/emergency evacuation plan
EMERGENCY RESPONSE PLAN These situations may indicate a fracture • Child complains of pain in a bone that gets worse with movement • Swelling or bruising over a bone • Child has deformed limb • Child is not using the limb • Child winces or looks like that may be uncomfortable during routine play or exercises • Contact the child’s parent/guardian. • If you are unable to contact the parent/guardian or alternate contact, call 911/EMS. • Inform the paramedics that the child has OI.
EMERGENCY RESPONSE PLAN • Do not move the affected area unless absolutely necessary • Make the child comfortable • Provide a blanket, a basin, or whatever else the child might need. • Do not provide food or drink • Staff should only apply a splint if the parent has instructed them to do so or if the child must be moved before a parent or other caregiver arrives
Child specific information • Type of OI • Safety precautions • Emergency Response Plan Health Care Plans are located in child file and binder
