椎体缺损,肛门闭锁,心脏缺陷,气管食管瘘或闭锁,肾脏异常,和肢体异常(VACTERL)关联是一种复杂的先天性疾病,其特征是存在影响各种器官系统的畸形。大多数患有VACTERL协会的儿童在出生后不久就需要手术,经常在婴儿期接受多种手术,这可能会导致广泛的身体挑战。这些儿童畸形的独特组合,除了需要满足复杂的护理需求外,还可能导致日常生活中的身体和社会困难,影响他们自己和照顾者的生活质量。在某些情况下,有复杂医疗需求的儿童被安置在寄养家庭。当具有复杂健康需求的儿童进入寄养系统时,有压倒看守人的风险,导致他们的需求继续得不到满足。儿科医生不仅在帮助支持家庭方面发挥作用,而且在了解哪些资源可以满足这些需求方面也发挥作用,这可能取决于他们的社区提供什么。儿科医生需要当前的培训才能适应该州的寄养系统。这种培训使儿科医生能够有效地与寄养家庭合作,同时还协助和协调复杂的护理以支持这些家庭。我们介绍了一个儿童在寄养系统中具有复杂的健康需求的案例,面对多重医疗保健挑战,因参加预约困难而延误护理。突出的是提供支持的重要性,个性化,以及为有复杂健康需求的儿童家庭提供多学科护理,包括当看护人在寄养系统内。
Vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula or atresia, renal anomalies, and limb abnormalities (VACTERL) association is a complex congenital condition characterized by the presence of malformations that affect various organ systems. Most children born with VACTERL association require surgery shortly after birth, often undergoing multiple procedures during infancy, which can lead to a wide range of physical challenges. The unique combination of malformations in these children in addition to having complex care needs that need to be met can result in physical and social difficulties in their daily lives, affecting both their own and their caregivers\' quality of life. In some cases, children with complex medical needs are placed in foster care. When children with complex health needs enter the foster care system, there is a risk of overwhelming the caretaker, leading to their needs continuing to be unmet. Pediatricians have a role not only in helping support families but also in knowing what resources are available to meet these needs, which can be dependent on what their communities offer. Pediatricians require current training to navigate their state\'s foster care system. This training allows pediatricians to effectively collaborate with foster families while also assisting and coordinating complex care to support these families. We present a case of a child with complex health needs placed in the foster care system, facing multiple healthcare challenges, with care delayed due to difficulty attending appointments. Highlighted is the importance of delivering supportive, personalized, and multidisciplinary care to families with children who have complex health needs, including when caretakers are within the foster care system.