About this Course
Preterm and medically complex infants are surviving at younger ages due to medical advances utilized in the neonatal intensive care unit. The co-morbidities of prematurity, post-surgical recovery, genetic conditions, and multi-system influences of these medical pathologies create an increased challenge to the neonatal therapist due to the fluctuating state of edema for the infant. This course is co-presented by leaders in the field of lymphatic mobilization and neonatal therapy. By co-presenting this topic, participants will receive the most up-to-date and evidence-based literature regarding the role of the lymphatic system, edema assessment, application of edema assessment within the NICU, and specific co-morbidities that warrant edema management to maximize outcomes. Clinical education will be provided regarding indications, contraindications, considerations during positioning/handling, oral motor facilitation, gross motor facilitation, pharmacological management, and additional interventions to support lymphatic transport of fluid. Clinical case studies with patient videos will be shared to enhance the participants learning. Upon completion of this session, participants will have a deeper understanding of the lymphatic system, the ability to integrate components of lymphatic care into clinical practice, use of edema assessment to create lymphatic care plans, and integrate oral/gross motor facilitation that will enhance lymphatic flow to reduce limitations in movement due to persistent edema.
OT, SLP, PT, RN, MD, and neonatal professionals
- Identify the role of the lymphatic system and gestational development as related to co-morbidities of prematurity, post-surgical interventions, and wound healing
- Apply individualized care planning with critical reasoning for the lymphatic flow of fluid regarding positioning, handling, and movement facilitation for premature and medically complex infants
- Assess premature/medically complex infant edema with consideration for type of edema and its influence on oral motor and gross motor movement to support development
Recorded webinar, lecture, videos, case studies, handouts, demonstrations, recorded questions, and answer session. Learning assessment and course evaluation follow the course.
Course Completion Requirements
The learner must view the entire webinar, complete the course evaluation, and complete the post-webinar learning assessment with at least an 80% to receive education credit. Login and logout times are recorded and documented. Following completion of this course physical therapists, nurses and other disciplines will receive a certificate of completion and a zip file containing information necessary to submit to their individual state for education credit. Zip file will include course bibliography. Physical therapists are responsible for knowing and adhering to their state’s deadlines, rules, and regulations.
Holly Schifsky, OTR/L, CNT, NTMTC, CBIS is an Occupational Therapist who has worked in pediatrics for the past 24 years with the past 16 years in a level IV NICU. She is a Certified Neonatal Therapist, Certified Neonatal Touch and Massage Therapist, Certified Brain Injury therapist, an active Member of National Association of Neonatal Therapists, and has completed 6-month mentorship in infant/child NDT. She has worked within the NICU and NICU follow-up clinic to maximize patient and family outcomes for the most complex premature and medically-fragile term infants. Holly received her Bachelor of Science degree in Occupational therapy from the University of North Dakota in 1997. She has dedicated her career to clinical care and advancing developmental care practice patterns for all multidisciplinary team members. She has presented at many regional and national conferences including National Association of Neonatal Therapists, American Physical Therapy Combined Sections Meeting, Audrey Harris Vision NICU conference, and the University of Minnesota NICU conference. She provides Developmental Care, Feeding Intervention, and NICU education throughout the country. She is a faculty member for the Neonatal Touch and Massage and Education Resources Inc. She is the recipient of the NANT Clinical Excellence award in 2018.
Sandy Sublett, PT, DPT, OCS, CLT is a physical therapist with over 35 years of clinical experience. She is board certified by APTA in orthopedics and holds certifications in wound care and lymphedema therapy. She is the leading national expert and educator on manual edema mobilization (MEM) with various publications and educational seminars offered throughout the country. She is an endorsed MEM instructor and program leader for MEM clinical advancement. She has provided professional education to clinicians at the national level, including CSM for APTA, and through multi-day CEU events. In the past five years, she has partnered with Holly Schifsky to advance edema mobilization clinical application for the neonate population.
Holly Schifsky, OTR/L, CNT, NTMTC, CBIS
Financial Disclosures: Presenter is a faculty member for Educational Resources Inc., and Neonatal Touch and Massage. Presenter receives speaking fees for these roles.
Nonfinancial Disclosures: No relevant disclosures.
Sandy Sublett, PT, DPT, OCS, CLT
Financial Disclosures: Presenter is an endorsed instructor of Manual Edema Mobilization continuing education courses and the lead/owner of Manual Edema Mobilization Associates, LLC. Presenter receives speaking fees when presenting most, but not all continuing education courses.
Nonfinancial Disclosures: No relevant disclosures.
Conflict of Interest
There is no conflict of interest for anyone with the ability to control content for this activity.
Part I: The Lymphatic System: Anatomy, Physiology, and its Vital Role
0:00-5:00 min: Introduction to topic
5:00-10:00 min: Review the critical role of the lymphatic system for the neonatal therapist
10:00-50:00 min: Lymphatic system review, including supporting literature
50:00-60:00 min: Edema assessment and classification
60:00-97:00 min: Manual edema mobilization (MEM) theoretical background
Part II: Integrating Lymphatic Considerations into Neonatal Therapy
0:00-15:00 min: Critical reasoning for lymphatic development, medical management, and NICU co-morbidities
15:00-30:00 min: Assessment of neonatal edema, including skin maturation, phases of pathology, and pharmacological interventions paired with NICU edema
30:00-44:00 min: Treatment considerations for edema management in the small baby (22-33 weeks gestation)
44:00-53:00 min: Treatment considerations for edema management and advancing goals for the maturing lymphatic system in infants 34 weeks gestation and older
53:00-63:00 min: Part 1 and Part 2 learning assessment
Part III: Supporting the Maturation of the Lymphatic System with MEM Principles
0:00-10:00 min: Clinical application of MEM in the NICU
10:00-18:00 min: Positioning/handling considerations for the acute phase of wound healing, complex edema, and the chronic phase of edema management
18:00-25:00 min: Neutral warmth, evidence-based practice to support flow of lymph fluid with temperature, focused handling techniques, and adjunct treatment to support neutral warmth
25:00-30:00 min: Diaphragmatic breathing, the role of the diaphragm with a focus on lymphatic activation, and facilitation techniques to increase diaphragm excursion and lymphatic transport
30:00-35:00 min: Exercise, sequence of movement facilitates lymphatic transport
35:00-40:00 min: Integrating lymphatic flow rate into clinical reasoning for motor development of lower extremities, upper extremities, and oral/pharyngeal region of premature infants
40:00-49:00 min: Case studies for NICU application, including outcomes
Part IV: Support Lymphatic Activation through Infant Developmental Activities
0:00-3:00 min: Neuro-lymphatic connection and emerging consideration of the glymphatic connection
3:00-10:00 min: Developmental considerations and caregiver training/home program for edema management
10:00-21:00 min: Summary of key concepts and recorded question and answer session
21:00-31:00 min: Part 3 and Part 4 learning assessment
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Continuing Education Information
National Association of Neonatal Therapists® (NANT) is an AOTA Approved Provider of professional development. Course approval ID#05071. This Distance Learning-Independent Course is offered at 0.4 CEUs (Intermediate level, Occupational Therapy Service Delivery & Professional Issues). AOTA does not endorse specific course content, products, or clinical procedures.
Learners must complete the entire course in order to receive ASHA CEUs. No partial credit awarded. ASHA CE Provider approval and use of the Brand Block does not imply endorsement of course content, specific products or clinical procedures.
ASHA CE Registry users: NANT will submit your ASHA CEU credit to ASHA on your behalf. ASHA CEUs may take up to 100 days to appear on your ASHA Transcript.
Non-ASHA CE Registry users: Maintain your course records and please keep your registry status current in your NANT account. Update your NANT account with your ASHA number if your registry status changes. NANT is not responsible for tracking your registry usage.
PT CE Credit
This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider 2501058TX and meets continuing competence requirements for physical therapist and physical therapist assistant licensure renewal in Texas.
Approved for 0.4 CEUs by the California Physical Therapy Association (CPTA) #21- CPTA #22-455
NANT is recognized by the New York State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapist assistant continuing education.
*NANT 12 attendees who previously viewed this educational content may retake this course and receive CE Credit.
Questions regarding CE credit should be directed to the National Association of Neonatal Therapists at firstname.lastname@example.org or (866) 999-5524.