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Pediatric Emergency Medicine Learning Checklist Family Medicine Resident Revised June 2020

The following learning checklist includes topics, presentations, and skills that may be reviewed during a Pediatric Emergency Medicine Rotation. Topics highlighted in bold indicate areas that correspond to Family Medicine Priority Topics, and these have been included in a separate column for reference. These areas may be covered during a Pediatric Emergency Rotation, but exposure may also occur during other rotations where pediatrics patients are seen. Details on Family Medicine learning objectives may be found at the following weblink. https://www.mcgill.ca/familymed/education/postgrad/curriculum-overview/resident-study-guide

Pediatric List Family Medicine 105 Priority Topics Rural and Remote 18 Priority Topics Intrapartum and Perinatal Care 24 Priority Topics

Allergy o #3.

Anesthesia o Local anesthesia # 58. Lacerations o Non-pharmacological approach to and anxiety o Procedural sedation; medication choices, #13 R&R. Procedural Sedation administration, complications o Bier Block: general principles and indications for use

Cardiovascular o Cardiovascular exam – distinction between normal #2. Advanced Cardiac Life and abnormal Support o ECG reading o Vital signs – normal values for each age group #22 IP&PC. First week of life o Acute Rheumatic Fever o Arrythmias o Congenital Heart Disease o Congestive heart failure o Endocarditis/Myocarditis/Pericarditis

Child maltreatment o Physical and sexual abuse- common presentations #4. Pediatric Emergencies o Differentiate between accidental and non- #98. Trauma accidental bruising o Fractures compatible with abuse o Physical and Sexual abuse; approach and management

Dermatology o #3. Allergy o Pediatric #82. o Fungal infections of skin and hair #90. Skin Disorder o Bites and Stings o Lice o

Endocrine o Adrenal Failure #26. Diabetes o DKA: acute management and complications #61. Loss of Consciousness o Hypoglycemia #86. Seizures o Hypocalcemia #7 R&R. Diabetic emergencies #12 R&R. Altered Level of Consciousness

#22 IP&PC. First Week of Life

Gastroenterology o Acute hepatic failure #1. Abdominal Pain o Dehydration #23. Dehydration o Gastroenteritis #27. Diarrhea o IBD- recognition of new onset and complications o Intestinal obstruction

Gynecology o Pregnancy; emergency conditions #1. Abdominal Pain o STDs/PID #23. Dehydration o Dysmenorrhea #33. Dysuria o Dysfunctional Uterine bleeding #52. In Children #79. Pregnancy #87. Sex #88. Transmitted Infections #101. Urinary Tract Infection #102. Vaginal Bleeding Hematology o Anemia #4. Anemia o Disseminated Intravascular Coagulation (DIC) #68. Neck pain o Hemophilia; trauma o Idiopathic (ITP) o Leukemia/Lymphoma o Sickle Cell Disease: crisis/fever

Infectious Disease o #5. Antibiotics o Cervical adenitis #21. Croup o Croup #23. Dehydration o Encephalitis #33. Dysuria o Epiglottitis #34. Earache o Fever without Focus; 0-6 weeks; 6weeks-3months; #40. Fever 3-36 months #45. Headache o #52. In Children o Lyme Disease #53. Infections o Meningitis #57. Joint Disorder o Osteomyelitis/septic arthritis #64 Meningitis o Otitis externa/Otitis media #69. Newborn o Pharyngitis #77. Pneumonia o Pneumonia #90. Skin Disorder o Septicemia including neonatal #99. Travel Medicine o Sinusitis #100. Upper Respiratory Tract o UTI Infection #101. Urinary Tract Infection

#3 R&R. Septicemia #9 R&R. Urgent Respiratory Presentations #22 IP&PC. First week of life

Nephrology o Dehydration; management #23. Dehydration o Acid –Base disturbances o Electrolyte disturbances o Hemolytic Uremic Syndrome o Henoch-Schonlein Purpura

Neurology o Increased intracranial Pressure #45. Headache o Migraine headache #61. Loss of Consciousness o Concussion and post concussive syndromes #86. Seizures o Seizures: febrile; afebrile; status epilepticus o VP shunt: obstructions; infection

Ophthalmology o Conjunctivitis #83. Red Eye o Corneal o Hyphema o Ocular

Orthopedics #41. Fractures o Radial head subluxation #10 R&R. Fractures and o Salter-Harris classification dislocation management

Psychiatry o Anxiety Disorders #6. Anxiety o ADHD/Behavior difficulties #10. Behavioural Problems o Aggressive or agitated patient: approach to #104. Violent / Aggressive Patient o Depression and suicidality: determining safety #6 R&R. Psychiatric Emergencies

Radiology- (indication and basic approach to the following) o Abdominal series #40. Fever o C-spine #41. Fractures o Chest X-Ray #68. Neck Pain o Lateral neck X-Ray #77. Pneumonia o Skull series

Resuscitation o Respiratory failure, shock and cardiopulmonary #2. Advanced Cardiac Life arrest: definitions and recognition, management Support o Team dynamics and roles #20. Crisis o Closed loop communication #69. Newborn

Respirology o Aspiration #7. Asthma o Asthma #13. Chest pain o Bronchiolitis #18. Cough o Cystic fibrosis- complications leading to ER #77. Pneumonia presentations #89. Shortness of Breath o Pneumothorax/pneumomediastinum #98. Trauma o Sudden Infant Death Syndrome o BRUE (Brief Unexplained Events)

Rheumatology o Kawasaki

Surgical Emergencies o Gastrointestinal foreign body o Incarcerated Hernia o Intestinal obstruction o Intussusception o Pyloric stenosis

Toxicology o Carbon Monoxide poisoning: assessment #78. Poisoning o Acetaminophen ingestion #96. Suicide o Ingestion – Basic Approach (ABCDE) #100. Upper Respiratory o Inhalational Presentations o Multiple or unknown ingestions o Salicylate ingestion

Trauma o ATLS principles – primary and secondary surveys #58. Lacerations o Bites: human and animal #90. Skin Disorder o : grading, BSA calculation, management #98. Trauma o Glasgow Coma Score o Head – minor #1 R&R. Trauma o management – cleaning and dressings

o Chest o Dental o Electrical o Near drowning o Solid organ injury o Hollow viscus injury o Urogenital injury

Urology o Balanitis o Phimosis o Testicular torsion

Approach to: FM Topic: o Abdominal mass - o Altered level of consciousness #61. Loss of Consciousness o Apneic/cyanotic episode #89. Shortness of Breath o Ataxia - o Behavioral Disturbance #10. Behavioural Problems o Bruising - o Chest Pain #13. Chest Pain o episodes - o Constipation - o Cough #18. Cough o Crying in infancy / childhood - o Diarrhea #27. Diarrhea o Dizziness/Vertigo #30. Dizziness o Dysuria #33. Dysuria o Earache #34. Earache o Edema - o Epistaxis #37. Epistaxis o Failure to Thrive - o Feeding problems in infancy - o Fever – basic principles, teaching families #40. Fever o Foreign body – ingestion and aspiration - o GI Bleeding #42. GI Bleed o Headache #45. Headache o Hematuria - o Hypertension #49. Hypertension o Jaundice - o Limp #57. Joint Disorder o Murmurs - o Neck Mass - o Neck Stiffness #68. Neck Pain o Oligomenorrhea - o Pallor - o Petechiae/Purpura - o Proteinuria - o Psychosis #85. Schizophrenia o Rash #82. Rash o Rectal Bleeding #42. GI Bleed o Red Eye #83. Red Eye o Respiratory Distress – mild #89. Shortness of Breath o Scrotal Pain / Swelling - o Sore Throat #53. Infections o Stridor #21. Croup o Swollen / Painful Joint #57. Joint Disorder o Syncope #61. Loss of Consciousness o Urinary frequency - o Urticaria #90. Skin Disorder o Vaginal discharge #103. Vaginitis o Visual Disturbances - o Vomiting - o Weakness - o Wheezing #7. Asthma

Skills (Knowledge of OR performance in simulated setting OR performance in clinical setting) o Bag / Mask Ventilation o Bier Block o dressing o Cardioversion/Defibrillation o C-spine immobilization o Chest compressions o Chest tube insertion o Dislocated radial head (pulled elbow) reduction o ECG – performing 12-lead o Eye irrigation o FAST o Fluorescein staining of eye o Fracture recognition and immobilization o Incarcerated hernia reduction o Incision and drainage of o Intraosseous insertion o Intravenous access o Joint exam o Lacerations – simple suturing and glue o Local anesthesia administration o Lumbar puncture o Monitor hook-up: saturation, cardiac o bed injury repair o Nasal cauterization o NG tube placement o Neurological exam at various ages o Oximetry – performance and interpretation o Paraphimosis reduction o drainage o POCUS o Procedural sedation o Splinting o Transurethral catheter placement o Urinalysis interpretations o Visual screening exam at various ages o Wound irrigation and debridement