Project ECHO in Paediatric Palliative Care

First Session on March 6, 2018
Zoom Meeting ID: 791138716
Starting time will be 2pm Indian Standard Time

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* 1. What is the name of your organization?

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* 2. Please tell us the contact information for the point person for this project at your organization:

Name

Position

Email Address

Phone Number

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* 3. Please tell us your contact information:

Name

Position

Email Address

Phone Number

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* 4. Please list the names and phone numbers for the other members of your team who will be attending

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* 5. Which of the following topics are of most interest to you (select as many as you like)

Opioids in Children

Neuropathic Pain in Children

Pain Assessment in Children

Procedural Pain Management

Anxiety in Children

Pain in Sickle Cell Disease

Neurological Conditions needing Palliative Care

Palliative Sedation in Children

Dyspnea in Children

Bereavement in Children

Communication in Chronic Pain

Communication of Bad News to Parents

Delirium in Children

Helping the Withdrawn Child

Methadone Use in Children

Regional Anesthesia in Children

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* 6. Please tell us any other topics that you want to know about in pediatric palliative care.

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* 7. In the past year, how many pediatric patients have you personally provided palliative care to?

None

<10

10-30

>30

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* 8. What percentage of patients in your practice need pediatric palliative care?

none

<25%

26-50%

51-75%

>75%