PICU

EDUCATIONAL GOALS AND OBJECTIVES

The educational objectives for the Emergency Medicine resident while on the Pediatric ICU rotation are as follows:

Patient Care

  • Demonstrate skill in infant/pediatric resuscitation.
  • Demonstrate correct airway management including pediatric endotracheal intubation.
  • Demonstrate the ability to perform conscious sedation with an understanding of potential drugs, dosing, advantages, and disadvantages.
  • Demonstrate the ability to obtain and utilize intravenous access including venipuncture, intraosseous needle placement, and administration of appropriate dose of emergency medications.
  • Demonstrate knowledge of the significance of fever in children of various ages, and the ability to perform an “optimal resuscitation” including Yale Observation Score of the febrile child.
  • Demonstrate knowledge of common infectious diseases of childhood, including appropriate work-up and treatment of meningitis, sepsis, pneumonia, urinary tract infection, and bacteremia.
  • Demonstrate knowledge of the pathophysiology and manifestations of common and/or serious disease of the gastrointestinal tract and abdominal cavity of children, including gastroenteritis, intussusception, volvulis, Meckel’s diverticulum, anaphylactoid purpura, and appendicitis.
  • State appropriate management of children with seizures, both febrile and afebrile.
  • Demonstrate familiarity with the diagnosis and management of Reye’s syndrome.
  • Demonstrate knowledge of hydrocephalus, its differential, treatment and the management of neuralgic shunt problems.
  • Calculate fluid and electrolyte requirements of dehydrated child.
  • Interpret a series of pediatric EKG’s showing awareness of the normal physiologic differences from adult EKG’s.
  • Demonstrate ability to read pediatric chest x-rays.
  • Demonstrate ability to properly treat patient who needs prophylaxis for rheumatic fever or sub-acute bacterial endocarditis.
  • Demonstrate correct management of the pediatric patient with diabetes and/or diabetic ketoacidosis.
  • Demonstrate knowledge of the differential diagnosis and work-up of the jaundiced child.
  • Demonstrate knowledge of differential diagnosis and evaluation of children with petechiae.
  • Demonstrate knowledge of the differential facial and orbital infections and their treatment.
  • Demonstrate proper performance of a suprapubic bladder aspiration.
  • Demonstrate knowledge of the common poisonings of childhood and their treatments.
  • Demonstrate ability to evaluate and treat a child with altered mental status and interpret a pediatric cranial CT scan.

Medical Knowledge

  • Discuss the causes, significance, and treatment of fever and infection in the child
  • Discuss the physiology and derangements of fluid and electrolyte management in children
  • Discuss the manifestations and treatment of pediatric cardiac abnormalities
  • Discuss the pathophysiology, causes, and treatment of common serious endocrine and hematological disorders of children
  • Discuss the pathophysiology, causes, and treatment of respiratory disorders in children
  • Discuss the common pediatric dysrhythmias, their diagnosis and treatment.
  • Discuss the types of congenital cyanotic and non-cyanotic heart disease, their complications and treatment.
  • Discuss the etiologies and demonstrate correct management of children with lower and upper airway disease including asthma, bronchiolitis cystic fibrosis, and pneumonia.
  • Discuss the differential diagnosis and work-up of the child with evidence of a bleeding disorder.
  • Discuss the findings and disposition of a patient with a suspected autoimmune syndrome such as juvenile arthritis, lupus, and dermatomyositis.
  • Discuss the causes of neonatal shock and demonstrate the ability to perform an infant resuscitation, including endotracheal intubation and insertion of an umbilical venous catheter.
  • State the differential diagnosis of a child with upper and lower GI bleeding, and discuss the evaluation and treatment.
  • Discuss the differential diagnosis and work-up of renal failure or anuria in children.
  • Discuss the signs, symptoms, treatment and complications of Kawasaki disease.

Practice Based Learning and Improvement

  • Demonstrate ability to obtain and appraise medical literature applicable to pediatrics

Interpersonal and Communication Skills

  • Create and sustain a therapeutic and ethically sound relationship with patients
  • Use effective listening skills and elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills
  • Work effectively with others as a member or leader of a health care team

Professionalism

  • Demonstrate respect, compassion, and integrity
  • Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
  • Demonstrate sensitivity and responsiveness to patients’ culture, age, gender, and disabilities

Systems-Based Practice

  • Understand how pediatric care affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their practice of Emergency Medicine

The Emergency Medicine resident will accomplish these objectives in the following manner:

  • Attend and participate in daily Pediatric Critical Care teaching rounds
  • Attend all conferences given be the Pediatric Critical Care Division while on rotation.
  • Evaluate and manage pediatric patients under the supervision of pediatric critical care faculty, senior residents and fellows in Pediatric Critical Care Medicine.  Progressive patient care responsibilities are at the discretion of the Pediatric Care Critical Care faculty based on the resident’s clinical experiences, didactic knowledge, psychomotor skills, procedural abilities and credentialing.
  • Discuss and interpret results of all ancillary testing with supervisory faculty.
  • Perform pediatric procedures under faculty supervision commensurate with their post-graduate level of training and skill.

 

ROTATION INFORMATION

Where: 5 th floor

When: Monday – Friday: 9:00 AM – 5:00 PM (If there is no procedure scheduled for the day, like LP, conscious sedation, you may leave after rounds)

Supervisor: Louisdon Pierre, MD, Chief of PICU

  • Ext: 8590

Attire: Scrubs and white coat

Expectations: Prepare yourself for the rotation by reviewing the pediatrics section of Tintinalli or Rosen. Review the meds for conscious sedation. On your first shift, introduce yourself to Dr. Pierre or Dr. Adeyinka. Usually you don’t carry patients, unless there’s a case you are interested in and want to follow. But, be prepared to actively participate in round discussions.