ROTATION DETAILS PGY-2 

Emergency Medicine Emergency Medical Service PICU Community ED Rotation Trauma

 

Pediatric Intensive Care Unit

 

OBJECTIVES

1.      To understand the pathophysiology of common problems presenting to the PICU (Medical knowledge and patient care).

2.      To understand the differences in care of pediatric ICU patients compared to adult ICU patients (System-based practice).

3.      To have an opportunity to place central lines in and to intubate critically ill pediatric patients and manage their ventilator care (Practice-based learning and improvement, patient care).

4.      To understand the vital sign differences in children and the decision-making process leading to a PICU admission (System-based practice, medical knowledge, practice-based learning and improvement).

5.      To become facile with the intravenous fluid management of ill children (Practice-based learning). Specific entities and disease processes with which the resident should become familiar include congenital heart disease; congenital airway abnormalities; DKA; metabolic disorders; malrotation syndromes; pseudomembranous enterocolitis; cardiac dysrhythmia; Reye's syndrome; meningitis; seizures; hydrocephalus; epiglottitis; croup; asthma; bronchiolitis; bronchopulmonary dysplasia; cystic fibrosis; pneumonia; scaled skin syndrome; sudden infant death syndrome; poisonings common to pediatrics; pediatric trauma principles; and nonaccidental trauma/child abuse (Medical knowledge, patient care).

6.      To learn how to communicate with parents when there is bad news (Communication skills).

7.      The resident should be familiar with the differential diagnosis of, workup, and management of the child with altered mental status; apnea; ataxia; hyper/hypothermia; burns; cardiac arrest; coma; cyanosis; dehydration; drowning; failure to thrive; hypertension; shock; syncope; stridor; wheezing; hematemesis; hematochezia; jaundice; and hematuria (Practice-based learning and improvement).

 

DESCRIPTION OF CLINICAL EXPERIENCE

·         Each resident will spend one month in the Pediatric ICU. The resident will work alongside Pediatric ICU fellows and intensivists. They will take regular night call (every fourth night).

 

DESCRIPTION OF DIDACTIC EXPERIENCE

·         Daily PICU rounds, monthly M&M conferences.

EVALUATION PROCESS

·         Written evaluation by PICU faculty.

 

FEEDBACK MECHANISM

·         Direct bedside feedback by PICU faculty and fellows. Written formatted rotation evaluations.

 

This rotation has been agreed to and approved by the Chairman of the Department of Pediatrics and the Director of the PICU. Residents are given rotation summaries at the beginning of their PGY-1 year. Residents should use rotation summaries, written rotation evaluations, and their performance on the In-service Examination to assess the rotation’s effectiveness.