Welcome to Peds ED at CCHMC

Welcome to your Peds ED month! The CCHMC ED will provide you ample opportunity to care for the acutely ill pediatric patient. You will care for children who clearly could have been cared for in the outpatient office, but you will also gain experience in identifying those children who require more emergent care and interventions. During the month you will have the opportunity to work directly with many of the outstanding CCHMC attendings and also work side by side with residents from CCHMC and UC (ED residents). This should be a great experience!

Prior to your first day, please be sure to complete the required Epic training along with reviewing the goals and objectives for the rotation. In addition to experiences at CCHMC, you are also required to complete asynchronous learning modules as outlined below. One of the requirements is the Asthma KSA from the ABFM. Please remember that the KSA's are for learning purposes and will be extremely challenging. We recommend you sit down early in the rotation and complete the entire KSA, following work through those that you missed over the next 1-2 weeks. 

  • 6 weeks prior to your rotation you will get an intro email from the CCHMC program coordinator with the following information: your CCHMC badge ID, parking information, EPIC training date with basic information, system access code, protocol to follow if ill or absent from a shift. Please reach out to Holly Hargraves if you did not get this introductory email.  

  • A week prior you will get a forwarded email from Holly Hargraves with specific rotation details provided by the Chief.  Please let Dr. Putnam know if you do not receive this email a week prior to the start of your rotation.

  • Interns only: 2 days prior to the EPIC session you will get an email with all your Epic information from an CCHMC Epic team member. Please reach out to Holly if you did not receive this email.

Community Practice Support Tools: This is a great resource for CCHMC guidelines on common diagnoses.

https://www.cincinnatichildrens.org/professional/resources/community-practice-support-tools

Required Encounter tracking

  • You will need at least 50 pediatric Emergency Department encounters to meet ACGME requirements. Please print out the form emailed to you by Dr. Putnam in your “welcome to the rotation” email and track your daily total of patient encounters. Keeping a daily log is best practice.

  • Turn this into to Holly by the end of the rotation.

Required Asynchronous Learning

  • ABFM KSA's (Previously called SAMS or Module II's). Please send screenshot of completion to Dr. Putnam.

    • Asthma KSA

  • Dermatology Modules: Please complete the AAD Dermatology Modules on common pediatric conditions. Go to this site: Basic Dermatology Curriculum (aad.org) and create a log in. This is free. After you create a login, please return to this page to directly access the modules. Select “Basic Dermatology Curriculum” and then select “two week rotation.” The webpage can take a while to download the first time you access the module, so be patient. Each module will have slides, videos (some do not), and a quiz. Click through the menus to find the following topics.

Required Epic Training

  • 2 days prior to the EPIC session you will get an email with all your Epic information from an CCHMC Epic team member. Please reach out to Holly if you did not receive this email. Judy will have this on your schedule on Medhub.

Goals and Objectives

  • Medical Knowledge

    • Recognize and initiate work up and treatment of common pediatric infections that may require hospitalization including but not limited to bronchiolitis, croup, epiglottitis, meningitis, skin and soft tissue infections, urinary tract infections, and fever in a neonate. R2

    • Recognize common pediatric respiratory conditions that may require hospitalization such as asthma exacerbation, bronchiolitis, and croup. R2

    • Recognize common musculoskeletal conditions that may require hospitalization such as trauma and abuse. R2

    • Recognize common neurologic disorders that may require hospitalization such as seizure disorders. R2

    • Recognize common GI/nutritional derangements that may require hospitalization such as dehydration and failure to thrive. R2

    • Recognize social, environmental, and physical risk factors that could predispose to the above conditions. R2

    • Generate a differential diagnosis that is relevant to the age and specific risk factors of the patient. R2

    • Review pertinent medical-legal issues including Good Samaritan laws, reportable conditions, duty to treat, and risk management. R2

  • Patient Care

    • Elicit a focused history that is age appropriate for the patient and carried out in a timely manner. R2

    • Demonstrate appropriate history and physical exam for signs and symptoms of child abuse (physical, emotional, sexual, etc). R2

    • Perform a targeted physical exam to distinguish between the above listed conditions as described under medical knowledge. R2

    • Assess and address adolescent specific health risk factors (including sensitive topics such as substance use and sexual activity) and social concerns including well-being at home, at school, and among peers. R2

    • Initiate the appropriate work up and treatment based on working differential diagnosis and the acuity of the patient’s problem. R2

    • Analyze data (laboratory, radiology, etc) and integrate the information into a revised differential diagnosis and modified treatment plan. R2

    • Perform supervised procedures as they apply to the clinical scenario (e.g. splinting, suturing, conscious sedation, etc). R2

    • Perform under supervision life-saving procedures and protocols as directed by PALS training. R2

    • Appropriately calculate weight based IV fluid bolus replacement and maintenance rates as well as electrolyte replacement. R2

    • Distinguish between those patients that can be treated in the emergency department and safely discharged home, and those who need more intensive monitoring and require hospitalization. R2

    • Perform POCUS applications to augment the pediatric exam for evaluation of patients for pyloric stenosis, intussusception, pneumonia, and hip joint effusion.

  • Interpersonal and Communication Skills

    • Effectively explain to patients and family/caregivers the working diagnosis, expected disease course, and management strategy. R2

    • Communicate with other members of the health care team including but not limited to admitting resident team, nurses, respiratory therapists, and social workers regarding the treatment plan. R2

  • Professionalism

    • Display empathy, compassion and integrity during interactions with patients and families. R2

    • Recognize the need for consultation with other areas of specialty. R2

  • System Based Practice

    • Communicate with primary care physicians the expected discharge needs and follow up course. R2

    • Effectively work as a member of a multidisciplinary team which may include nurses, admitting resident team, specialty consultants, and social work. R2