scholarly journals Development of a Model for Admitting Pediatric Trauma Casualties in the Emergency Department

2019 ◽  
Vol 34 (s1) ◽  
pp. s58-s59
Author(s):  
Raya Tachlizky Madar ◽  
Bruria Adini ◽  
David Greenberg ◽  
Avishay Goldberg
Keyword(s):  
Emergency Medicine ◽  
Pediatric Trauma ◽  
Severe Trauma ◽  
Pediatric Emergency ◽  
Case Managers ◽  
Pediatric Care ◽  
National Council ◽  
Mortality And Morbidity ◽  
Qualitative And Quantitative ◽  
Medical Teams

Introduction:Pediatric trauma is one of the leading causes of child mortality and morbidity and is a major challenge for healthcare systems worldwide. Treatment of pediatric trauma requires special attention according to the unique needs of children, especially in children affected by severe trauma who require life-saving treatments. It is essential to examine the preparedness of Emergency Departments (EDs) for admitting and treating pediatric casualties.Aim:To develop a model for admitting and treating pediatric trauma casualties in EDs.Methods:Seventeen health professionals were interviewed using a semi-structured qualitative tool. A quantitative questionnaire was distributed among general and pediatric EDs’ medical and nursing staff. Following the qualitative and quantitative findings, another round of interviews was performed to identify constraints, to construct a “Current Reality Tree,” and develop a model for admission and management of pediatric casualties in EDs. The model was validated by the National Council for Trauma and Emergency Medicine.Results:Lack of uniformity was found regarding age limit and levels of injury of pediatric patients. Most study participants believe that severe pediatric casualties should be concentrated in designated medical centers and that minor and major pediatric casualties should be treated in pediatric rather that general EDs. Pediatric emergency medicine specialists are preferred as case managers for pediatric casualties. Significant diversity in pediatric-care training was found. Based on qualitative and quantitative findings, a model for the optimal admitting and managing of pediatric casualties was designed.Discussion:To provide the best care for pediatric casualties and regulate its key aspects, clear statutory guidelines should be formulated at national and local levels. The model developed in this study considers EDs’ medical teams and policy leaders’ perceptions, and hence its significant contribution. Implementation of the findings and their integration in pediatric trauma care in EDs can significantly improve pediatric emergency medical services.

scholarly journals Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
T. Ahluwalia ◽  
S. Toy ◽  
C. Gutierrez ◽  
K. Boggs ◽  
K. Douglass
Keyword(s):  
Emergency Medicine ◽  
Self Efficacy ◽  
Pediatric Emergency ◽  
Pediatric Care ◽  
Procedural Skills ◽  
Knowledge And Skills ◽  
Post Graduate ◽  
Pediatric Emergencies ◽  
Simulation Based

Abstract Background Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees’ self-efficacy, knowledge, and skills in pediatric care. Methods We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention. Results Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline. Conclusions A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees’ self-efficacy, knowledge, and skills in pediatric emergency care.

scholarly journals Pediatric Trauma Boot Camp: A Simulation Curriculum and Pilot Study

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ahmad Khobrani ◽  
Nirali H. Patel ◽  
Richard L. George ◽  
Neil L. McNinch ◽  
Rami A. Ahmed
Keyword(s):  
Emergency Medicine ◽  
Pilot Study ◽  
Survey Methodology ◽  
Pediatric Trauma ◽  
Boot Camp ◽  
Pediatric Emergency ◽  
Basic Knowledge ◽  
Convenience Sample ◽  
Simulation Based ◽  
Trauma Curriculum

Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees’ basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern’s curricular conceptual framework. This was a pilot, prospective, single cohort, exploratory, observational study utilizing survey methodology and a convenience sample. The curriculum consisted of a two-day experience that included confidence surveys, a cognitive multiple-choice questionnaire, and formative and summative simulation scenarios. At the conclusion of this intensive simulation-based trauma boot camp participants reported increased confidence and demonstrated significant improvement in the basic knowledge and performance of the management of pediatric trauma cases in a simulated environment.

Exploring the Differences in Macrocognition Between Experts and Non-CHD Experts Managing Congenital Heart Disease (CHD)

2021 ◽  
Vol 10 (1) ◽  
pp. 335-339
Author(s):  
Azadeh Assadi ◽  
Peter C. Laussen ◽  
Patricia Trbovich
Keyword(s):  
Decision Making ◽  
Emergency Medicine ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Emergency ◽  
Acute Management ◽  
Naturalistic Decision Making ◽  
The Face

Background and aims: Children with congenital heart disease (CHD) are at risk of deterioration in the face of common childhood illnesses, and their resuscitation and acute management is often best achieved with the guidance of CHD experts. Access to such expertise may be limited outside specialty heart centers and the fragility of these patients is cause for discomfort among many emergency medicine physicians. An understanding of the differences in macrocognition of these clinicians could shed light on some of the causes of discomfort and facilitate the development of a sociotechnological solution to this problem. Methods: Cardiac intensivists (CHD experts) and pediatric emergency medicine physicians (non-CHD experts) in a major academic cardiac center were interviewed using the critical decision method. Interview transcripts were coded deductively based on Klein’s macrocognitive framework and inductively to allow for new or modified characterization of dimensions. Results: While both CHD-experts and non-CHD experts relied on the macrocognitive functions of sensemaking, naturalistic decision making and detecting problems, the specific data and mental models used to understand the patients and course of therapy differed between CHD-experts and non-CHD experts. Conclusion: Characterization of differences between the macrocognitive processes of CHD experts and non-CHD experts can inform development of sociotechnological solutions to augment decision making pertaining to the acute management of pediatric CHD patients.

Milestones Comparisons from Residency to Pediatric Emergency Medicine Fellowship: Resetting Expectations

2021 ◽  
Author(s):  
Tien T. Vu ◽  
Jerri A. Rose ◽  
Veronika Shabanova ◽  
Maybelle Kou ◽  
Noel S. Zuckerbraun ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine

Pediatric Emergency Medicine Fellows’ Milestone Evaluations: Do they all meet the targets for graduation?

2021 ◽  
Author(s):  
Cindy G. Roskind ◽  
Kathryn Leonard ◽  
Aline Baghdassarian ◽  
Maybelle Kou ◽  
Kelly Levasseur ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Pediatric Emergency ◽  
Pediatric Emergency Medicine
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