{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:59:51Z","timestamp":1777877991972,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,7,18]],"date-time":"2020-07-18T00:00:00Z","timestamp":1595030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NASN School Nurse"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>An important subgroup of children with special healthcare needs are those children with medical complexities who require long-term intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes shunts systems (e.g., a ventriculoperitoneal shunt) to drain excess cerebrospinal fluid. These devices put children at serious medical or surgical risk when they malfunction or become infected, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management. This article describes the initial assessment and management of common medical emergencies in students who have those devices.<\/jats:p>","DOI":"10.1177\/1942602x20940036","type":"journal-article","created":{"date-parts":[[2020,7,18]],"date-time":"2020-07-18T04:03:58Z","timestamp":1595045038000},"page":"86-91","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["School Nurses on the Front Lines of Healthcare: Children With Medical Devices\u2014Shunt System Malfunctions and Infections"],"prefix":"10.1177","volume":"36","author":[{"given":"Noa","family":"Farou","sequence":"first","affiliation":[{"name":"Penn State University College of Medicine, Hershey, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christy","family":"Lucas","sequence":"additional","affiliation":[{"name":"Penn State University College of Medicine, Hershey, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-4473","authenticated-orcid":false,"given":"Robert P.","family":"Olympia","sequence":"additional","affiliation":[{"name":"Professor, Departments of Emergency Medicine and Pediatrics, Penn State College of Medicine, Attending Pediatric Emergency Medicine physician, Penn State Hershey Medical Center, Hershey, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,7,18]]},"reference":[{"key":"bibr1-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Agarwal N., Kashkoush A., McDowell M. M., Lariviere W. R., Ismail N., Friedlander R. M. (2018). Comparative durability and costs analysis of ventricular shunts. Journal of Neurosurgery, 130(4), 1252-1259. https:\/\/doi\/org\/10.3171\/2017.11.JNS172212","DOI":"10.3171\/2017.11.JNS172212"},{"issue":"2","key":"bibr2-1942602X20940036","first-page":"1","volume":"13","author":"Bober J.","year":"2016","journal-title":"Pediatric Emergency Medicine Practice"},{"key":"bibr3-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Burger M. C., Wagner M., Franz K., Harter P. N., B\u00e4hr O., Steinbach J. P., Senft C. (2018). Ventriculoperitoneal shunts equipped with on-off valves for intraventricular therapies in patients with communicating hydrocephalus due to leptomeningeal metastases. Journal of Clinical Medicine, 7(8), Article 216. https:\/\/doi.org\/10.3390\/jcm7080216","DOI":"10.3390\/jcm7080216"},{"key":"bibr4-1942602X20940036","unstructured":"Food and Drug Administration. (2019). Magnetic field interference with programmable CSF shunts. https:\/\/www.nasn.org\/advocacy\/professional-practice-documents\/positionbriefs\/pb-wearable"},{"key":"bibr5-1942602X20940036","author":"Fowler J. B.","year":"2019","journal-title":"Ventriculoperitoneal shunt"},{"key":"bibr6-1942602X20940036","unstructured":"Hydrocephalus Association. (n.d.). Shunt systems. https:\/\/www.hydroassoc.org\/shunt-systems\/"},{"key":"bibr7-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Miller J. P., Fulop S. C., Dashti S. R., Robinson S., Cohen A. R. (2008). Rethinking the indications for the ventriculoperitoneal shunt tap. Journal of Neurosurgery: Pediatrics, 1(6), 435-438. https:\/\/doi.org\/10.3171\/PED\/2008\/1\/6\/435","DOI":"10.3171\/PED\/2008\/1\/6\/435"},{"key":"bibr8-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Mizrahi C. J., Spektor S., Margolin E., Shoshan Y., Ben-David E., Cohen J. E., Moscovici S. (2016). Ventriculoperitoneal shunt malfunction caused by proximal catheter fat obstruction. Journal of Clinical Neuroscience, 30, 120-123. https:\/\/doi.org\/10.1016\/j.jocn.2015.11.029","DOI":"10.1016\/j.jocn.2015.11.029"},{"key":"bibr9-1942602X20940036","unstructured":"National Association of School Nurses. (2018). Wearable medical technology in schools: The role of the school nurse (Position brief). https:\/\/higherlogicdownload.s3.amazonaws.com\/NASN\/3870c72d-fff9-4ed7-833f-215de278d256\/UploadedImages\/19_-_Wearable_Medical_Technology_in_Schools_Position_Brief.pdf"},{"key":"bibr10-1942602X20940036","unstructured":"National Association of School Nurses. (2020). Use of individualized healthcare plans to support school health services (Position statement). https:\/\/higherlogicdownload.s3.amazonaws.com\/NASN\/3870c72d-fff9-4ed7-833f-215de278d256\/UploadedImages\/PDFs\/Position%20Statements\/20_-_PS_-_Use_of_Individualized_Healthcare_Plans_042020.pdf"},{"key":"bibr11-1942602X20940036","unstructured":"Olympia R., Doctor K. (2009, November 8). Emergency management of the technology-assisted child. https:\/\/www.reliasmedia.com\/articles\/115765-emergency-management-of-the-technology-assisted-child"},{"key":"bibr12-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Paff M., Alexandru-Abrams D., Muhonen M., Loudon W. (2018). Ventriculoperitoneal shunt complications: A review. Interdisciplinary Neurosurgery, 13, 66-70. https:\/\/doi.org\/10.1016\/j.inat.2018.04.004","DOI":"10.1016\/j.inat.2018.04.004"},{"key":"bibr13-1942602X20940036","doi-asserted-by":"crossref","unstructured":"Pan P. (2018). Outcome analysis of ventriculoperitoneal shunt surgery in pediatric hydrocephalus. Journal of Pediatric Neurosciences, 13(2), 176. https:\/\/doi.org\/10.4103\/jpn.JPN_29_18","DOI":"10.4103\/JPN.JPN_29_18"}],"container-title":["NASN School Nurse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1942602X20940036","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1942602X20940036","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1942602X20940036","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:08:13Z","timestamp":1777590493000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1942602X20940036"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,18]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/1942602X20940036"],"URL":"https:\/\/doi.org\/10.1177\/1942602x20940036","relation":{},"ISSN":["1942-602X","1942-6038"],"issn-type":[{"value":"1942-602X","type":"print"},{"value":"1942-6038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,18]]}}}