Pediatric Emergency Medicine

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Pediatric Emergency Medicine

• Roger M. Barkin, M.D

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Pediatric Emergency Medicine

• US conjoint specialty board reflecting the
  biology of emergency medicine and pediatrics.
• Its history is relatively short, but its impact
  has been tremendous.

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History

• 1933 American Board of Pediatrics (AAP)
• 1968 American College of Emergency Physicians
  (ACEP)
• 1976 American Board of Emergency Medicine
• (primary board in 1989)
• 1980 First PEM fellowship established in
  Philadelphia
• 1981 Section of Pediatric Emergency Medicine of
  AAP
• 1984 Task Force created by ACEP and AAP
• 1988 Section of Pediatric Emergency Medicine of
  ACEP
• 1991 Joint PEM sub-board established
• 1992 First PEM certification examination

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Educational Program

• Fellowship training
• Residency training
• PALS and APLS
• Nursing and paramedic

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Certification

• Prior certification in pediatrics or emergency
  medicine
• Two or three year fellowship

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Clinical Settings - Hospital

• Emergency Department - Goals
• Expedite Care
• Quality of Care
• Marketing
• Community Service

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Clinical Settings - Hospital

• Emergency Department - Requirements
• Volume
• Institutional philosophical financial
  committment

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Clinical Settings - Hospital

• Emergency Department - Settings
• Pediatric specialized facility/area
• Mixed use facility
• 30 of general ED population is pediatric
• No differentiation

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Clinical Settings - Hospital

• Emergency Department - Environment
• Interior decorating
• Toys
• Play areas
• Distractive therapy (videos/games)

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Clinical Settings - Hospital

• Emergency Department - Personnel
• Physicians
• Nursing
• Physician assistants/extenders
• Laboratory
• Radiology

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Clinical Settings - Hospital

• Emergency Department - Equipment
• Resuscitation
• Standard Supplies

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Clinical Settings - Hospital

• Emergency Department - Observation Units
• Educational Programs
• PALS

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Clinical Settings - PreHospital

• Equipment
• Personnel
• Training

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Clinical Settings - In-patient

• Pediatric specialized facility
• Mixed-use facility
• Hospital within a hospital

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Clinical Focus

• Protocols
• Analgesia and sedation
• Rapid sequence induction (RSI)
• Trauma
• Child abuse/neglect
• Special needs children

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• Equipment and Training
• Literature/Research

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• Education
• and
• Prevention