Pediatric Medicine Comprehensive Review Series

Title: PDcc-Pediatrics – Critical Care: Life-Threatening Infections; Seizures; Flaccid Myelitis

Faculty: Robert A. Belfer, M.D., Michael J. Muszynski, M.D., F.A.A.P.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

TOPIC 1: Life-Threatening Pediatric Infections.

Upon completion of this session, using national Evidence Based Medicine sources including Cochrane Collaboration and published guidelines from sources including the American Academy of Pediatrics, the participant should be able to: ^{EBM, GL,} COMP

1. Conclude that as newer immunizations eradicate many serious infections, we are still faced with certain pathogens that can cause severe morbidity and mortality.
2. Recognize, diagnose and manage the following diseases:
   1. Toxic Shock Syndrome;
   2. Meningococcemia;
   3. Rocky Mountain Spotted Fever;
   4. Kawasaki Syndrome.
3. Develop an approach to the patient who presents with fever and a rash.

TOPIC 2: Pediatric Seizures I. Status Epilepticus, II. Febrile Seizures.

Upon completion of this session, using national Evidence Based Medicine sources including Cochrane Collaboration and published guidelines from sources including the American Academy of

Pediatrics, the participant should be able to: ^{EBM, GL,} COMP

1. Demonstrate appropriate medications to treat pediatric status epilepticus.
2. Utilize the literature concerning epidemiology of febrile seizures in educating patients’ families.

TOPIC 3: Acute Flaccid Myelitis. 

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Recognize the clinical manifestations of AFM and apply the clinical, laboratory, and case classification criteria as defined by the Centers for Disease Control (CDC).
2. Compare other known neurological entities in the differential diagnosis of a patient with suspected AFM.
3. Recommend appropriate diagnostic testing for AFM and reporting method to health authorities.
4. Apply the interim considerations for clinical management of AFM according to the latest expert opinion defined by CDC.

Title: PDem-Pediatrics – Critical Care: Life-Threatening Infections; Seizures; Flaccid Myelitis

Faculty: Robert A. Belfer, M.D., Mark D. Joffe, M.D., Richard J. Scarfone, M.D.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

TOPIC 1: Trauma in the Pediatric Patient

Upon completion of this session, using evidence-based medicine and guidelines from the 4th International Symposium on Concussion in Sport, the participants should be able to: ^{EBM, GL, COMP}

1. Describe the pathophysiology and, using evidence-based medicine, develop clinical strategies for the emergency treatment of head injury/concussion in childhood.
2. Apply an evidence-based medicine approach to decisions regarding obtaining a CT scan in children after minor head trauma.
3. Recognize the signs and symptoms of concussions in pediatric patients.
4. Recognize common pediatric fractures and learn how to manage them and when to refer to Orthopedics.

TOPIC 2: Diagnosis and Misdiagnosis of Appendicitis in Childhood

Upon completion of this session, using evidence-based medicine, the participant should be able to: ^{EBM COMP}

1. Review the pathophysiology of appendicitis.
2. Associate the pathophysiology of appendicitis with the signs and symptoms.
3. Analyze various diagnostic approaches to appendicitis in childhood.
4. Criticize the care provided in several cases of appendicitis missed at the time of initial ED evaluation.

TOPIC 3: Visual Diagnosis

Upon completion of this session, the participant should be able to: ^{EBM, COMP}

1. Demonstrate the ability to identify diagnoses in children by simple visual inspection.
2. Discriminate among common pediatric diagnoses by asking appropriate historical questions.
3. Employ Evidence Based Medicine and Guideline based management of diseases such as Lyme, Bell’s Palsy, DKA, and other commonly seen disorders.

Title: PDid-Pediatrics – Infectious Diseases: UTI; Animal Bites; Kawasaki Disease

Faculty: Stephen C. Eppes, M.D., F.A.A.P., Michael J. Muszynski, M.D., F.A.A.P.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

SPECIFIC OBJECTIVES FOR EACH TOPIC:

TOPIC 1: Pediatric Urinary Tract Infections.

Upon completion of this session, using the evidence-based guidelines from the AAP, the participant should be able to: ^{EBM, GL, COMP}

1. Determine the clinical situations in which urinary tract infections should be considered.
2. Appraise diagnostic methods for urinary tract infection, characterize their reliability and application, and recognize their limitations.
3. Employ the most appropriate treatment options.
4. Assess the controversies concerning follow-up and prevention strategies.

TOPIC 2: Bites! Dogs, Cats, Critters, Humans, and Alligators.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Stratify management of bite wounds according to risk and potential infectious etiologies based upon animal type, bite location, bite severity, and hospitalization risk factors.
2. Apply recommendations for wound management in bite injuries and targeted antimicrobial therapy when infection occurs.
3. Utilize appropriate antimicrobial and other important prophylaxis for bite wound and apply these according to evidence-based recommendations.
4. Counsel patients and families on bite wound prevention

TOPIC 3: Kawasaki Disease.

Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Recognize clinical/laboratory manifestations of Kawasaki
2. Evaluate and manage patients according to AAP/AHA guidelines.
3. Recognize the potential for coronary complications.

Title: PDtr-Pediatrics - Trauma: Abdominal Trauma; Head Injuries; Upper Extremity Fractures

Faculty:Jeffrey A. Seiden, M.D., F.A.A.P., Rakesh D. Mistry, M.D., M.S.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

SPECIFIC OBJECTIVES FOR EACH TOPIC: 

TOPIC 1: Blunt Abdominal Trauma in Children.

Upon completion of this session, using evidence-based medicine and published guidelines, the participant should be able to: ^{EBM, GL, COMP}

1. Recognize injury mechanisms and clinical findings that are characteristic of solid organ injury and hollow viscus injury in children.
2. Integrate the role of various laboratory and radiologic tests in the diagnosis of solid organ injury and hollow viscus injury in children.
3. Develop and employ appropriate management strategies for children with significant intra-abdominal injuries.
4. Appraise recent data regarding the utility of focused abdominal sonography in trauma (FAST) in pediatric trauma.

TOPIC 2: Head Injuries in the Pediatric Patient.

Upon completion of this session, using evidence-based medicine and guidelines from the 4th International Symposium on Concussion in Sport, the participants should be able to: ^{EBM, GL, COMP}

1. Describe the pathophysiology and, using evidence-based medicine, develop clinical strategies for the emergency treatment of severe head injury in childhood.
2. Apply an evidence-based medicine approach to decisions regarding obtaining a CT scan in children after minor head trauma.
3. Recognize the signs and symptoms of concussions in pediatric patients.
4. Demonstrate use of currently recommended management approaches in children with concussion.

TOPIC 3: Upper Extremity Fractures in Children Upon completion of this session, the participant should be able to: ^{GL, COMP}

1. Develop an age-appropriate evaluation to upper extremity fractures in children.
2. Detect common upper extremity fractures using common diagnostic and radiographic techniques.
3. Evaluate indications for emergent and outpatient orthopedic consultation in children with upper extremity injuries.

Title: PDwe-Pediatrics - Wellness: Child Physical Abuse; Pain Management; Foreign Body Aspirated/Ingested

Faculty: John M. Loiselle, M.D., F.A.A.P., Richard J. Scarfone, M.D., F.A.A.P., Mark D. Joffe, M.D.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

SPECIFIC OBJECTIVES FOR EACH TOPIC:

TOPIC 1: Clinical Clues to Detecting Child Physical Abuse

Upon completion of this session, the participant should be able to: ^{COMP, GL}

1. Identify findings that are characteristic of physical abuse.
2. Distinguish physical findings often confused with physical abuse.
3. Formulate further evaluation based on the most recent AAP guidelines.

TOPIC 2: Pain Management in the Office and ED

Upon completion of this session, the participant should be able to:  ^{EBM, GL, COMP}

1. Employ the American Society of Anesthesiologists, American Academy of Pediatrics, and American College of Emergency Physicians fasting guidelines for procedural sedation.
2. Manage the pain associated with specific illnesses or injuries commonly seen in an office setting.
3. Manage the pain and sedation needs of children with specific illnesses or injuries commonly seen in an ED.

TOPIC 3: Dilemma of the Foreign Body – Aspirated or Ingested

Upon completion of this session, using evidence-based medicine, the participant should be able to: ^{EBM, COMP}

1. Distinguish the epidemiology and clinical presentation of aspirated versus ingested foreign bodies.
2. Analyze the rationale for radiographic evaluation of children with a history of foreign body ingestion.
3. Review the diagnostic approach and radiographic interpretation of children with aspirated foreign bodies.