Common Goals for Pediatric Level 1 and Level 2 Residents

• The pediatric residents will have an understanding of the fundamental elements of a physician/patient relationship including the parents right to receive information, discuss risks and benefits of procedures, and have questions answered.
  
  
• The pediatric resident will understand the right of patients to have available adequate healthcare with courtesy, respect, and dignity.
  
  
• The pediatric resident will develop the skills and competence to take an accurate problem-focused emergency history and apply information obtained from history and physical examination to formulate an appropriate differential diagnosis while being attentive to emergent issues.

Pediatric Level 1

• The pediatric resident will develop the competence and skills to recognize serious and/or critically ill or injured children.
  
  
  • be capable of recognizing and managing compensated and decompensated shock
    
    
  • be capable of recognizing and providing initial management of children with respiratory distress and/or failure
    
    
  • acquire the skills and competence to recognize and evaluate potential surgical emergencies including:
    
    
    • appendicitis
      
    • intussusception
      
    • bowel obstruction
      
    • testicular torsion
      
    • incarcerated hernia
      
      
  • be able to understand and interpret upper and lower limits of vital signs in infants and children from newborn through adolescence
    
    
  • be capable of performing a mental status examination on all ages of patients including Glasgow Coma Score, Pediatric Glasgow Coma Score, and recognition of focal neurologic signs that suggest the need for emergency intervention.
    
    
• The pediatric resident will have the skills and competence to perform life-saving procedures which include:
  
  
  
  • basic cardiopulmonary resuscitation, bag-value-mask ventilation, measuring and inserting oral and nasal airways
    
  • control of exsanguinating external hemorrhage
    
    
• The pediatric resident will obtain the skills and develop competence in performing the following diagnostic procedures:
  
  
  • lumbar puncture
    
  • arterial blood sampling
    
  • intravenous access
    
  • foreign body removal from ears/nose
    
  • splinting of simple fractures
    
  • reduction of radial head subluxation
    
  • repair of simple and two layer complex lacerations
    
  • whole bowel irrigation for poisonings
    
    
• The pediatric resident will have the skills and competence to calculate emergent drug doses and select appropriate equipment for resuscitation of all age infants and children.

• The pediatric resident will develop the skills and competence to evaluate and manage common acute and episodic urgent problems seen in pediatrics to include:
  
  
  • febrile infant and child
    
  • reactive airway disease inlcuding asthma
    
  • stridor and croup
    
  • vomiting, gastroenteritis, and dehydration
    abdominal pain

Pediatric Level 2

• The pediatric resident will be capable of recognizing potential emergencies in infants and children with signs and symptoms that are often common and seemingly benign including:
  
  
  
  • chest pain
    
  • syncope
    
  • headache
    
  • the limping child
    
  • seizures
    
  • stridor
    
  • abdominal pain
    
  • altered consciousness
    
    
• The pediatric resident will develop competency in managing children with special healthcare needs who present with emergencies including:
  
  
  
  • sickle cell crisis
    
  • the immune-compromised, febrile infant
    
  • the diabetic in ketoacidosis
    
  • complications from congenital heart problems
    
  • ventriculoperitoneal shunt obstruction

• The pediatric resident will be skilled in managing cardiopulmonary arrests and patients with multiple trauma including severe head trauma.

• The pediatric resident will develop the skills and competence to recognize and manage toxic ingestions in infants and children.

• The pediatric resident will be skilled in recognizing and managing the physically abused, neglected, and sexually abused child and adolescent.

• The pediatric resident will obtain the skills and develop confidence in performing the following procedures:
  
  
  • emergency endotracheal intubation
    
  • conscious and dissociative sedation
    
  • central line placement
    
  • needle thoracostomy
    
  • suprapubic bladder puncture
    
  • insertion of arterial line
    
  • removal of esophageal foreign bodies
    
  • paraphimosis reduction
    
  • eye examination including lid eversion and fluorescein examination
    
  • digital block
    
  • drainage of subungual hematoma
    
  • incision and drainage of abscesses and paranychia
    
  • management of minor burns