Pediatric Critical Care Resident Rotation

Rotation Goal:

Resident will competently evaluate, diagnose and treat common acute/critical pediatric medical and surgical conditions presenting in the PICU. Residents will recognize and appropriately manage acutely ill pediatric patients.

Learning Objectives Required To Meet Specific Rotation Goals:

1. Recognizes an acutely ill pediatric patient in need of immediate evaluation and treatment.
2. Initiates basic stabilization measures and obtains assistance for definitive care.
3. Manages the evaluation and treatment of 2-3 typical PICU patients simultaneously.
4. Effectively communicates with attending, nursing, referring and consulting staff for the most efficient management of each patient.
5. Utilizes laboratory, radiology and consulting services in an appropriate and cost effective manner.
6. Recognizes patient concerns which cannot be adequately addressed in a PICU setting. Develops a plan with patient/parents for non-emergent evaluation.
7. Develops an appropriate follow-up plan for all patients seen and communicates with the patient’s primary physicians during and upon discharge from PICU.

Communicates effectively with patients and parents regarding their presenting concerns.

Medical Knowledge:

Read Pediatric Critical Care textbook sections, update articles and evidenced based literature pertinent to the specific area goals as well as articles relevant to patient care problems encountered:

• • Fever in an infant under three months of age
  • Fever without a source at any age
  • Asthma and status asthmaticus
  • Croup
  • Acute viral bronchiolitis
  • Acute respiratory failure
  • Acute cardiac decompensating conditions
  • Drowning
  • Fractures
  • Multiple trauma
  • Abdominal pain and surgical abdomen
  • Intussusception/ other bowel obstructions
  • Foreign Bodies (airway, esophagus)
  • Seizures – febrile and afebrile
  • Closed head injuries
  • Meningitis
  • Status epilepticus
  • Vomiting, diarrhea and dehydration
  • Shock: septic, volume depletion and cardiogenic
  • Supraventricular tachycardia and other dysrhythmias
  • Diabetic ketoacidosis
  • Ingesting known and unknown substances
  • Physical and sexual abuse

Patient Care

1. 1. Recognizes an acutely ill pediatric patient in need of immediate evaluation and treatment.
   2. Initiates basic stabilization measures and obtains assistance for definitive care.
   3. Manages the evaluation and treatment of 2-3 typical PICU patients simultaneously.
   4. Performs the following procedures and log in new innovations a minimum for four of these following procedures during their rotation:
      
      

1. 1. • Lumbar puncture
      • Venipuncture and arterial puncture
   2. • IV placement
   3. • Central line placement (observation)
      • Intraosseous placement
      • Intubation
   4. • Chest tube placement (observation)
      • Nasogastric/Orogastric tube insertion
   5. • Foley catheter (urinary bladder) catheterization

Professionalism:

1. 1. 1. Resident will demonstrate behavior consistent with high professional standard. 100% attendance, timeliness, perceived as handling appropriate caseload in a timely fashion

Communication and Interpersonal Communication Skills:

1. 1. 1. Communicate effectively with attending, nursing, referring and consulting staff for the most efficient management of each patient.
      2. Communicates effectively with patients and parents regarding their presenting concerns

Practice-Based Learning and Improvement:

1. 1. 1. Work seamlessly with inter-professional teams to enhance patient safety and improve patient care quality.
      2. Constantly evaluates own performance

Systems-Based Practice:

1. 1. Develops an appropriate follow-up plan for all patients seen and communicates with the patient’s primary physicians when necessary
Recognizes patient concerns which cannot be adequately addressed in a PICU setting. Develops a plan with patient/parents for non-emergent evaluation