Medical Student Curriculum Guide
Knowledge—Pediatric Emergencies

Rationale

Identifying an infant, child, or adolescent with a medical emergency, and approaching the patient in an organized and aggressive fashion, may significantly reduce morbidity and mortality.

Learning Objectives

1. Identify the patient who requires immediate medical attention and intervention.

2. Describe the initial emergency management of shock, seizures, severe respiratory distress, lethargy, apnea, and status epilepticus in childhood.

3. Recognize those situations in which concern about intentional injury should be raised. Describe findings suggestive of non-accidental trauma.

4. For the following acute clinical presentations, discuss the clinical findings, and distinguish between different diagnoses, for an infant/child taking into account the age of the patient:

Pediatric Emergencies Table

Emergent Clinical Problem	Diagnoses to Consider (Core pediatric level)	Diagnoses to Consider (mastery pediatric level)
Airway Obstruction / Respiratory distress	Croup, bronchiolitis, asthma, pneumonia, foreign body aspiration, anaphylaxis	peritonsillar or retropharyngeal abscess
Altered mental status (Delirium/lethargy)	Head injury, increased ICP, substance abuse, infection (encephalitis, meningitis), diabetic ketoacidosis, hypoglycemia, abuse, shock, hypoxemia.	intussusception
Apnea	acute life-threatening event (ALTE), seizures, and respiratory infections (RSV and pertussis), GERD, sepsis	cardiac dysrhythmias, breath holding spells
Ataxia		ingestion, infection, and tumor
Gastrointestinal bleeding	Meckel’s diverticulum, fissure, intussusception	inflammatory bowel disease, allergic colitis, peptic ulcer disease
Injuries and accidents	Animal bites, minor head injury, nursemaids elbow	sprains and fractures, burns, near drowning, lacerations
Proptosis		tumor and orbital cellulitis
Seizures	Infection (i.e., meningitis or encephalitis), status epilepticus, febrile, ingestion, hypoxemia, shock, electrolyte disturbances	tumor
Shock	Sepsis, severe dehydration, diabetic ketoacidoses, anaphylaxis, congestive heart failure and ingestion.	Burns, neurogenic shock, ductal dependent heart lesions, and adrenal insufficiency
Suicidal Ideation	Depression

Competencies

1. For each condition listed in the right hand column of the table, provide the acute clinical presentation and initial diagnostic assessment.

2. Demonstrate the appropriate anticipatory guidance to prevent life-threatening conditions (e.g. infant positioning for sudden infant death syndrome (SIDS), locks to prevent poisoning, and the use of car seats and bicycle helmets).

3. Recognize how the signs of shock in a child differ from those of an adult.


Copyright 2003 Medical College of Georgia All rights reserved.	School of Medicine \| Medical College of Georgia Please email comments, suggestions or questions to: Kenda Rindt, krindt@mail.mcg.edu. June 29, 2006

Medical Student Curriculum Guide Knowledge—Pediatric Emergencies

Medical Student Curriculum Guide
Knowledge—Pediatric Emergencies