5/7/09 PEDS ER
PEDIATRIC ER – Children’s Medical Center
GOALS AND OBJECTIVES
_____________________________________________...
5/7/09 PEDS ER
The pediatric ER rotation is a required 4 week experience. It takes place at Children’s
Medical Center (CMC...
5/7/09 PEDS ER
2. Coordinate care to facilitate discharge and address the patient’s on-going needs.
3. Provide appropriate...
5/7/09 PEDS ER
8. Identify the clinical manifestations and describe an initial approach to patients with
suspected physica...
5/7/09 PEDS ER
1) The resident will be evaluated by the ER attending using standard evaluation form.
Satisfactory completi...
5/7/09 PEDS ER
1) The resident will be evaluated by the ER attending using standard evaluation form.
Satisfactory completi...
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Pediatric Emergency Medicine

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Pediatric Emergency Medicine

  1. 1. 5/7/09 PEDS ER PEDIATRIC ER – Children’s Medical Center GOALS AND OBJECTIVES ________________________________________________________________________ ROTATION DIRECTOR Hong Xiao, MD Hong.xiao@utsouthwestern.edu Office 214-648-1318 Pager 214-745-0510 ROTATION SUPPORT Patti Pagels, MPAS, PA-C Patti.pagels@utsouthwestern.edu Office 214-648-1301 Cell 817-980-2651 SPECIAL FACULTY Susan Scott, MD CMC Dept of Emergency Medicine 1935 Motor St. Dallas, TX 75235 214-456-2735 214-456-6233 (fax) ROTATION CONTACT PERSONNalinda Charnsangavej, MD Chief Residents for 2009-2010 nalinda.charnsangavej@childrens.com Elizabeth Keyes, MD Elizabeth.Keyes@childrens.com Dale Lee, MD dale.lee@childrens.com Phone: 214-456-2735 ROTATION DAYS/HOURS Shift work/ 16 twelve-hour shifts FAMILY MEDICINE CLINIC One half day Family Medicine Resident Clinic Tuesday Afternoon Resident Conference CALL FREQUENCY No call VACATION No vacation allowed in this month INTRODUCTION 5/7/09 PEDS ER
  2. 2. 5/7/09 PEDS ER The pediatric ER rotation is a required 4 week experience. It takes place at Children’s Medical Center (CMC) of Dallas in an Emergency Department specializing in the care of infants and children. EDUCATIONAL GOALS Upon completion of this rotation a resident should be able to: Patient Care 1. Obtain focused history and physical exam on acute care issues of children in the emergency room, develop a differential diagnosis, order appropriate tests, and establish a diagnosis with treatment plan. 2. Facilitate admission or discharge with appropriate parent/patient education focusing on prevention and safety. Communication 1. Explain medical care/procedure with staff, colleagues, upper level residents, fellows and faculty. 2. Communicate effectively with patients and their families across a wide range of socioeconomic and cultural backgrounds. . Medical Knowledge 1. Identify and establish care for common emergent/urgent medical problems. Practice-Based Learning 1. Solve pediatric emergent/urgent problem using evidence based medicine to improve patient care. System-Based Learning 1. Document pediatric issues promptly and efficiently. 2. Coordinate care of pediatric patients using resources at CMC, the Dallas Community and the region. Professionalism 1. Work together with emergency medical staff and consultants to improve patient care, decrease cost, promote wellness, provide patient education, and prevent disease. 2. Practice ethical, reasonable medical care for all. 4 Follow all the policies of the program at Parkland Hospital and respect the policies of UTSW and CMC. EDUCATIONAL ACTIVITIES To achieve these goals the residents will: Patient Care 1. Do a focused emergent history and physical exam to stabilize and treat emergent/urgent ill child, order appropriate lab test to establish a diagnosis and provide treatment. 5/7/09 PEDS ER
  3. 3. 5/7/09 PEDS ER 2. Coordinate care to facilitate discharge and address the patient’s on-going needs. 3. Provide appropriate patient/care-giver education about disease prevention and safety issues. 4. Demonstrate the ability to manage and/or perform the following: a. Minor laceration repair b. Foreign body removal (eye, ear, skin, nose) c. I & D of soft tissue infection d. Minor burns e. Sprains, strains and simple fractures f. Bladder catheterization g. Lumbar puncture h. Calculate fluid loss and order replacement fluids accordingly i. Nebulizer treatments for acute exacerbations of asthma j. Genital exams on sexually-active adolescents k. Place an IV line Communication 1. Discuss the emergent/urgent pediatric medical problem with parent, patients, and family in a practical and caring language. 2. Discuss in an effective and proficient manner the medical care for the emergent/urgent ill child with staff, colleagues, upper level residents, fellows, faculty and other members of the healthcare team. Medical Knowledge The Resident will be able to: 1. Discuss common etiologies of cardio and respiratory distress in children and infants and describe appropriate management for these conditions. 2. Recognize the significance of pre-hospital care and the emergency medical system. 3. Discuss the management of an infant/child with status epilepticus. 4. Summarize the approach to a patient with ingestion of a known or unknown substance and recite common toxidromes. 5. Recognize the clinical manifestations and initially manage patients with foreign bodies of the esophagus and/or tracheobronchial tree. 6. Demonstrate the ability to assess and manage the patient with head trauma and state the indications for imaging procedures and neurosurgical consultation. 7. Develop a differential diagnosis and initial approach to a patient presenting with the following signs or symptoms: a. Coma b. Cyanosis c. Lethargy d. “Septic” appearance e. Unexplained respiratory distress f. Apnea g. Fever h. Limping i. Abdominal pain j. Dehydration 5/7/09 PEDS ER
  4. 4. 5/7/09 PEDS ER 8. Identify the clinical manifestations and describe an initial approach to patients with suspected physical abuse or neglect. 9. Recognize the clinical manifestations and initiate management of patients who you suspect have been sexually abused. 10. Recognize and initially manage a patient with smoke inhalation. 11. Summarize the initial management of the patient with near drowning. 12. Recognize the importance of the multi-disciplinary approach to the patient with significant trauma. 13. Recognize and initially manage reactive airway disease and bronchiolitis. 14. Complete the following modules in MedChallenger: (under the section entitled Pediatric Resuscitation) • Pediatric airway emergencies • Pediatric cardio-pulmonary resuscitation • Pediatric Fluids and Electrolytes • Pediatric Intravenous Catheterization Practice-Based Learning 1. Use evidence based medicine to solve pediatric emergent/urgent care problem and assess current emergent/urgent knowledge and recommendations. System-Based Learning 1. Code for emergency service and emergency procedures. 2. Coordinate resources of CMC and the Dallas Community to provide improved patient care. 3. Follow state guidelines for proper reporting of child abuse or neglect. Professionalism 1. Demonstrate being able to work together with emergency medicine staff and consultants to improve patient care, decrease cost, promote wellness, provide patient education, and prevent disease. 2. Practice ethical, reasonable medical care for all. 3. Demonstrate responsible behavior with emergency staff and patients. 4. Follow all the policies of the program at Parkland Hospital and respect the policies of UTSW and CMC. METHODOLOGY The residents will see patients in the emergency department at Children’s Medical Center and the office of family practice resident clinic. FAMILY PRACTICE CLINIC The resident will be in Family Practice Clinic one half-day per week (Wednesday) during the rotation. EVALUATION PROCESS 5/7/09 PEDS ER
  5. 5. 5/7/09 PEDS ER 1) The resident will be evaluated by the ER attending using standard evaluation form. Satisfactory completion of rotation will be determined by Program Director of the Family Medicine Residency Program in consultation with the ER attending. 2) Complete the evaluation on EValue of the rotation 3) Complete by the end of the rotation the questions in the sections identified in MedChallenger 4) Complete the tasks contained in the Passport for this rotation READING LIST: At the discretion of and with the guidance of the ER attendings. 1. Harriet Lane Handbook 2. Nelson’s Pediatrics 3. Avery, Pediatric Medicine 5/7/09 PEDS ER
  6. 6. 5/7/09 PEDS ER 1) The resident will be evaluated by the ER attending using standard evaluation form. Satisfactory completion of rotation will be determined by Program Director of the Family Medicine Residency Program in consultation with the ER attending. 2) Complete the evaluation on EValue of the rotation 3) Complete by the end of the rotation the questions in the sections identified in MedChallenger 4) Complete the tasks contained in the Passport for this rotation READING LIST: At the discretion of and with the guidance of the ER attendings. 1. Harriet Lane Handbook 2. Nelson’s Pediatrics 3. Avery, Pediatric Medicine 5/7/09 PEDS ER

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