Curriculum Competencies and Objectives

PREFACE | PROFESSIONAL CONDUCT AND ATTITUDES | SKILLS | HEALTH SUPERVISION | GROWTH | DEVELOPMENT | BEHAVIOR | NUTRITION | PREVENTION |ISSUES UNIQUE TO ADOLESCENCE | ISSUES UNIQUE TO THE NEWBORN | MEDICAL GENETICS AND DYSMORPHOLOGY | COMMON ACUTE PEDIATIC ILLNESS | COMMON CHRONIC ILLNESS AND DISABILITY | THERAPEUTICS | FLUID AND ELECTROLYTE MANAGEMENT | POISONING | PEDIATRIC EMERGENCIES | CHILD ABUSE | CHILD ADVOCACY | COMMON PEDIATRIC ILLNESS TABLE | CLINICAL ENCOUNTER TABLE | DIAGNOSIS LIST | CURRICULUM DEVELOPMENT PARTICIPANTS

PEDIATRIC EMERGENCIES

Rationale
Prerequisites
Competencies
Processes

Rationale

All health care providers must be able to identify the infant, child, or adolescent with a medical emergency. A systemic and thorough approach to the seriously ill child may significantly reduce morbidity and mortality.

Prerequisites

• Knowledge of the cardiopulmonary responses to decreased or relatively decreased intravascular volume.
• Certification in basic cardiopulmonary resuscitation.

Competencies

Knowledge

1. List the symptoms of and describe the initial emergency management of shock, respiratory distress, lethargy, apnea, and status epilepticus in pediatric patients. (CP)
2. Describe the age-appropriate differential diagnosis and the key clinical findings that would suggest a diagnosis for each of the emergent clinical problems in the table below.
3. Describe the clinical findings for each of the diagnosis to consider in the table below.

Pediatric Emergencies Table

Emergent Clinical Problem	Diagnoses to Consider (Core pediatric level)	Diagnoses to Consider (mastery pediatric level)
Airway Obstruction / Respiratory distress	Croup, bronchiolitis, asthma, pneumonia, foreign body aspiration, anaphylaxis	peritonsillar or retropharyngeal abscess
Altered mental status (Delirium/lethargy)	Head injury, increased ICP, substance abuse, infection (encephalitis, meningitis), diabetic ketoacidosis, hypoglycemia, abuse, shock, hypoxemia.	intussusception
Apnea	acute life-threatening event (ALTE), seizures, and respiratory infections (RSV and pertussis), GERD, sepsis	cardiac dysrhythmias, breath holding spells
Ataxia		ingestion, infection, and tumor
Gastrointestinal bleeding	Meckel's diverticulum, fissure, intussusception	inflammatory bowel disease, allergic colitis, peptic ulcer disease
Injuries and accidents	Animal bites, minor head injury, nursemaids elbow	sprains and fractures, burns, near drowning, lacerations
Proptosis		tumor and orbital cellulitis
Seizures	Infection (i.e., meningitis or encephalitis), status epilepticus, febrile, ingestion, hypoxemia, shock, electrolyte disturbances	tumor
Shock	Sepsis, severe dehydration, diabetic ketoacidoses, anaphylaxis, congestive heart failure and ingestion.	Burns, neurogenic shock, ductal dependent heart lesions, and adrenal insufficiency
Suicidal Ideation	Depression (U)

Skills

1. Demonstrate the appropriate anticipatory guidance to prevent life-threatening conditions (e.g. infant positioning for sudden infant death syndrome (SIDS), locks to prevent poisoning, and the use of car seats and bicycle helmets) (see also Prevention). (CP)
2. Demonstrate the "ABC" assessment as a means for identifying who requires immediate medical attention and intervention. (U)

Processes

All students on the pediatric clerkship should see a patient or patients, real or simulated, with respiratory distress

Click here to link to the Clinical Case Scenarios.