Our Experts

2021

The primary objective was to survey pediatric emergency medicine (PEM) leaders and fellows regarding point-of-care ultrasound (POCUS) training in PEM fellowship programs, including teaching methods, training requirements, and applications taught. Secondary objectives were to compare fellows' and program leaders' perceptions of fellow POCUS competency and training barriers.

2021

POCUS is a growing field in medical education, and an imaging modality ideal for children given the lack of ionizing radiation, ease of use, and good tolerability. A 2019 literature review revealed that no US pediatric residency programs integrated obligatory POCUS curricula. Our objective was to provide a formalized POCUS curriculum over multiple years, and to retrospectively assess improvement in resident skills and comfort.

2019

There has been a steady increase in the growth and utilization of point‐of‐care ultrasound (POCUS) in pediatric emergency medicine (PEM). POCUS has been established as an Accreditation Council for Graduate Medical Education (ACGME) core requirement for accreditation of PEM fellowship programs. Despite this requirement, training guidelines regarding POCUS knowledge and skills have yet to be developed. The purpose of this project was to develop a curriculum and a competency checklist for PEM fellow POCUS education.

Children and adolescents develop different types of cancers than adults. The 5-year survival rate for all childhood (0 to 19 years of age) cancers in the United States has been steadily increasing and is currently 83% to 84%1; however, malignant neoplasms remain the second leading cause of death for U.S. children age 5 to 14 years.2 The most common childhood malignancies are discussed below.

Bleeding in a child can be a diagnostic dilemma, because the causes range from benign to serious. Children with mild bleeding disorders may not experience an episode of bleeding until faced with a hemostatic challenge, such as an interventional procedure or trauma. On the other hand, children without an underlying bleeding disorder commonly present with complaints of bruising and bleeding such as epistaxis or menorrhagia. Red flags for a potential bleeding disorder include bleeding or bruising out of proportion to the injury, prolonged and/or recurrent bleeding (particularly with unknown cause or after a small injury or procedure), spontaneous bruising or bleeding, uncommon sites of bleeding (joints, GI) or bruising (proximal extremities, trunk), and a family history of a bleeding disorder. Consider nonaccidental trauma in the child with unusual bruising patterns (see Chapter 150, “Child Abuse and Neglect”). Figure 144-1 provides a basic approach for the initial ED assessment of a child with bleeding. The most common bleeding disorders presenting in childhood are discussed below.