PEDIATRIC EMERGENCY MEDICINE 

ROTATION INFORMATION

Year: UNM R2s, Shiprock and Santa Fe Interns

Rotation contact information:

•  Dr. Tara Neubrand, Pediatric ED Medical Director
• Elizabeth Talamantes, Coordinator - 277-2892 ETalamantes@salud.unm.edu

Location:  Department of Emergency Medicine; UNMH 1st floor

Pre-requisites: none

Important Notes: 

-The attendings you will work with don't know your schedule, so if you are getting close to the end of your shift it's ok to let the attending/senior know that your shift is nearing it's end so that you can plan together about which patients to see

-There is a cultural expectation that is also best practice for patient care that if you take on a patient with a lot of social complexity- calling the CART team, or CYFD, or other things like that- that you continue to be the provider for that patient and family until everything is done.  This shouldn't preclude you from caring for these patients, it is a very important learning experience with great guidance from the Peds ED team.  But it's also helpful for planning.

PEM Orientation Handout Link: https://app.smartsheet.com/b/publish?EQBCT=64480aa4a9224180b83509910c6f08f5​

Clinical Resources Handout Link:  https://app.smartsheet.com/b/publish?EQBCT=a70d0cb16d6a4ddd96a6d5b289cc4b5c

**Sick Leave:  If calling in sick please follow the procedures below:

Sick Call Protocol

In the event of illness or unexpected events, please:

Greater than 24hrs before scheduled shift

· Email Scheduler etalamantes@salud.unm.edu and Residency Liaison mfbustillos@salud.unm.edu to see what options there are

      Less than 24hrs before scheduled shift · Email hsc-emed-pedsickcall@salud.unm.edu, cc attending you are scheduled to work with and your program (chiefs, program manager, and PD)

Less than 2 hours before scheduled shift

· Tiger text Elizabeth Talamantes immediately (Scheduler)

Email FM Program Manager dlgarcia@salud.unm.edu;

SCHEDULES! -- Check Tiger Schedule for most up-to-date schedule!!  If you are inappropriately scheduled after a night shift, contact Elizabeth Talamantes as above.  

For R1 (1+2) schedule page, click here 

Schedule A: if there's only one FM upper level on peds ED

Schedule B: (used if more than 1 FM upper level resident is on Peds ED)

GOALS 

The goal of the pediatric curriculum is to provide FP residents with learning opportunities that will enable them to develop or refine knowledge, skills and attitudes necessary to 

1. See at least 75 patients in the month (both R1s and upper levels).  This is from an ACGME pediatric ED requirement that we need to track. We track these by looking at notes so you don't need to log them

2. Diagnose and manage common pediatric disorders

3. Recognize, triage and coordinate consultation of complex pediatric conditions

4. Provide education and support for patients and families living with pediatric disorders

5. Effectively communicate with all members of the healthcare team

6. Develop a professional identity that emphasizes individual, practice and system improvement

OBJECTIVES 

PATIENT CARE

The resident will demonstrate:

1. the ability to obtain, document and report a developmentally and age appropriate pediatric history.

2. the ability to perform, document and report a developmentally and age appropriate pediatric examination.

3. the ability to generate an appropriate differential diagnosis.

4. the ability to make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.

5. the ability to perform appropriate procedures, with attention to consent, technique, patient comfort and follow-up.

6. the ability to counsel and educate patients and their families in a clear, respectful and culturally conscious manner.

7. the ability to develop and implement an appropriate follow-up plan that includes attention to the medical and psycho-social dimensions involved and incorporates the patient’s family, the primary care physician and appropriate consultants.

MEDICAL KNOWLEDGE

The resident will demonstrate:

1. knowledge of normal vital signs, lab values, growth and development.

2. recognition of changes or variation in vital signs, lab values, imaging results, growth and development that should trigger evaluation.

3. knowledge of the indications, application & interpretation of commonly used laboratory, imaging, developmental and behavioral assessments.

4. the ability to recognize, evaluate and appropriately treat sepsis

5. the ability to recognize, evaluate and appropriately treat dehydration

6. the ability to recognize, evaluate and appropriately treat respiratory distress

7. the appropriate initial assessment and stabilization of trauma/injury

8. the ability to determine appropriate medication dosage for weight and/or age.

9. knowledge of the various presentations of child abuse & neglect, the appropriate approach to the patient and family and the legal obligations related to reporting.

PRACTICE-BASED LEARNING AND IMPROVEMENT

The resident will:

1. recognize his/her own strengths and limitations.

2. apply medical evidence to inpatient clinical situations, using a logical approach that is inclusive of the individual patient.

3. use appropriate resources such as literature, consultants and peers to provide best patient care.

4. ask questions as an engaged, critical learner.

INTERPERSONAL AND COMMUNICATION SKILLS

The resident will:

1. make organized and effective oral presentations.

2. communicate with the patient and family in a timely, developmentally and culturally appropriate manner.

3. communicate clearly and respectfully with medical team members, consultants, nursing, social work, discharge planning, and other staff.

PROFESSIONALISM

The resident will:

1. accept responsibility for patient care.

2. never misrepresent patient care information.

3. be punctual, reliable and collegial.

4. demonstrate dress, hygiene and manner of speech that consistently reflect appropriate standards.

5. demonstrate sensitivity towards patients’ and colleagues’ gender, age, culture, disabilities, ethnicity and sexual orientation.

6. demonstrate sensitivity to the stressors of the family with an ill child, and the needs of that child.

SYSTEMS-BASED PRACTICE

The resident will:  practice patient advocacy and use system resources to minimize discomfort or confusion, recognize that the patient is part of greater system and provides care in a manner that supports continuity.

Procedural skills:

The resident will demonstrate proficiency in:  laceration repair 

The resident will document/demonstrate experience with: lumbar puncture, splinting/immobilization 

The resident will demonstrate understanding of: sedation

As always, please see the competency based rotation goals