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(2010) 'Pediatric procedural skills training curriculum', MedEdPortal, 6, p. 8094. Their diverse backgrounds and experience infuse CDEM’s content with notable expertise. However, there are inadequate numbers of patients available to ensure that all trainees are exposed to, learn about, and perform these critical procedures. Needle aspiration of primary spontaneous pneumothorax', N Engl J Med, 368(19), p. e24. Some aspects that participants found most valuable about the workshop included hands-on practice (86%), small group learning (29%), working with experts (14%), ability to ask questions (14%), the fast pace of the day (14%), and multiple opportunities to practice the same procedure (14%). To our knowledge, this is the first study to describe the implementation of and to examine the effectiveness of a one-day simulation workshop for critical procedures in PEM. CPT Code 99291 is used for the first 30-74 minutes of critical care time; CPT Code 99292 is used for additional blocks of time of up to 30 minutes beyond the first 74 minutes of critical care time; Must document either a specific time or, e.g., "in excess of 30 minutes". Conclusion: This one-day simulated procedural workshop was able to expose relevant trainees and providers to rare and critical procedures. [email protected], MedEdPublish Editorial Office,
After the workshop, participants had increased agreement regarding their ability to name the indications, contraindications, equipment and procedural steps necessary for almost all procedures. She is the associate program director of the Pediatric EM fellowship and a clinical researcher interested in improving detection of child abuse and developing interventions to improve family violence. After the workshop, the proportion of participants that somewhat or strongly agreed to being able to name these procedural knowledge categories increased in almost all areas. We accept unsolicited (completed) manuscripts, and welcome your proposals. AMEE, While procedural training has been developed for EM and pediatric residents in various procedures. It’s the kind of hard-hitting, no-frills information you need. Critical Procedure Videos. Finally, station 8 incorporated nurse and pediatric emergency medicine attending instruction of intravenous (IV) catheter placement (visual and ultrasound guided), intraosseous (IO) infusion, and knee arthrocentesis. Build your clinical arsenal with CDEM’s case-based lessons and monthly features on diagnostic imaging, ECG interpretation, critical procedures, toxicology, and more. Her research interests include quality improvement, behavioral health, and medical education. 533-8. Nestor-Arjun, B. and Miano, M. (2014) 'Orientation to emergency pediatric procedures', MedEdPortal, 10, p. 9852. Dev, S. P., Nascimiento, B., Jr., Simone, C. and Chien, V. (2007) 'Videos in clinical medicine. Hosts Danya Khoujah, MBBS, and Wendy Chang, MD, entertain and inform with real-life cases and new clinical approaches to managing everything from animal bites and broken bones to drug withdrawal and stab wounds. We’re proud to introduce Critical Decisions’ new editor-in-chief, Michael Beeson, MD, FACEP. Small groups rotated through 8 stations: advanced airway, cricothyroidotomy and translaryngeal ventilation, pericardiocentesis, central venous catheterization, tube thoracostomy, vascular access, arthrocentesis, and vaginal delivery. https://doi.org/10.1097/PEC.0000000000000991, Mittiga, M. R., Geis, G. L., Kerrey, B. T. and Rinderknecht, A. S. (2013b) 'The spectrum and frequency of critical procedures performed in a pediatric emergency department: implications of a provider-level view', Ann Emerg Med, 61(3), pp. Placement of a femoral venous catheter', in N Engl J Med. Get the latest indications, dosing protocols, and precautions in our Tox and Drug Boxes. Thomsen, T. W., Shen, S., Shaffer, R. W. and Setnik, G. S. (2006) 'Videos in clinical medicine. https://doi.org/10.1056/NEJMvcm0909669, Mittiga, M., Geis, G., Kerrey, B. and Rinderknecht, A. Station 4, covering umbilical catheters, included a neonatal manikin and an umbilical line tray. Inserting a central venous catheter, securing intravenous access, and performing FAST scan under ultrasound guidance 3. (2013a) 'The Spectrum and Frequency of Critical Procedures Performed in a Pediatric Emergency Department: Implications of a Provider-Level View', Annals of Emergency Medicine, 61(3), pp. Methods: Learners who care for acutely ill children were invited to attend. The Emergent Procedures Simulation Skills Lab teaches emergency medicine practitioners critical skills for the critical-care environment. She is Medical Director of the Pediatric Emergency Department and Director of Quality and Safety for GME. You will be sent an email with instructions for accessing your account. Paul, R. I. and King, L. (1996) 'Technical skills experiences in pediatric emergency medicine fellowship programs', Pediatr Emerg Care, 12(1), pp. www.acep.org. 78-83. https://doi.org/10.1111/1742-6723.12514, Ortega, R., Song, M., Hansen, C. J. and Barash, P. (2010) 'Videos in clinical medicine. (2006) 'Distributed practice in verbal recall tasks: A review and quantitative synthesis', Psychol Bull, 132(3), pp. Our local small-group workshop targets the rare and critical procedures in children in which pediatric emergency providers are required to attain competency and which training programs may not have a formalized process to teach. Procedural training and practice at each station was conducted over approximately 20 minutes and included a brief instructor-led discussion and demonstration followed by hands-on experience with the simulation equipment. 10-2. She is the program director for the Pediatric Emergency Medicine fellowship and a representative on the Subspecialty Pediatric Investigative Network, where she participates in multicenter medical education scholarship. This study was granted exemption from the Human Research Protection Program, our institutional review board. Performing thoracostomy procedures using traditional chest tube insertion methods and percutaneous chest tube insertion utilizing minimally invas… Sawyer, T., Creamer, K., Puntel, R., Lin, J., et al. Lastly, the impact of the coronavirus pandemic on the future of these large group gatherings is unclear. The majority of participants somewhat or strongly agreed to being able to name all of the indications for all critical procedures. Calculated time must exclude all separately billable procedures 76-82. A senior neonatology fellow instructed. Kern, D., Thomas, P. and Hughes, M. (2009) Curriculum Development for Medical Education: A Six-Step Approach. The results are revealing. It’s the kind of hard-hitting, no-frills information you need. Station 7 covered surgical airway management, instructed by a pediatric ear nose and throat surgeon. United States, p. pp. During the session, participants were evenly divided into 8 small groups (a group of 3 learners for each procedural station). There are at several limitations to this work. Station 3 covered tube thoracostomy, taught by a surgical senior resident. Suggestion for improvement included additional time at certain procedural stations. Many physicians in PEM report infrequently performing critical procedures in the ED, while some report not having performed an emergency procedure like an intubation since graduation from residency (Paul and King, 1996; Al-Eissa et al., 2008; Petrosoniak, Herold and Woolfrey, 2013; Burns and Uspal, 2017; Petrosoniak et al., 2017). Free on-line medical education tools were used as primers for the workshop. ', CJEM, 15(4), pp. Several studies have documented that neither pediatric EM (PEM) fellows nor EM residents have an opportunity to perform any of these critical procedures on children (Al-Eissa et al., 2008; Petrosoniak, Herold and Woolfrey, 2013). ORCID ID: Al-Eissa, M., Chu, S., Lynch, T., Warren, D.. Anderson, J., Leonard, D., Braner, D. A., Lai, S. Burns, R. A. and Uspal, N. G. (2017) 'Procedural Training and Assessment for Pediatric Emergency Medicine Physicians Within the United States and Canada: A Survey Study', Pediatr Emerg Care. , there may still remain a gap in the training of PEM providers in these critical procedures. Tissue replacement, Surgical airway tray (includes scalpel, tracheal hook, clamp, forceps, tracheal dilator, retractor). Each station was manned by a faculty expert and participants had 20 minutes to learn and practice each procedure on task trainers. Sawyer, T., Creamer, K., Puntel, R., Lin, J.. 292-293. https://doi.org/10.3928/00220124-20180613-02. Both direct and indirect patient care time can be included in critical care billing. 263-70. (2012) 'Videos in clinical medicine. The post-session survey was administered immediately following the experience. 241-8. e15. We partnered with our on-site simulation center to provide the task trainers, space, and disposable equipment for the procedure training. Dr. Beeson, who has served on the publication’s Editorial Board for more than a decade, is the immediate past president of the Council of Residency Directors (CORD), and the director of the Emergency Medicine Residency Program at Akron General Hospital in Akron, Ohio.