Emergency Paediatrics
Draft proposed by Dr Simon To, Dr Frankie Cheng
Reviewed by Dr Winnie Tse
Essential Skills
Domain 1 Professional Values & Behaviour
Domain 3 Procedural skills
Domain 4 Patient Management
Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises
Basic Training
Emergency room paediatrics
Resuscitation of a critically ill child
Assessment of a febrile child
Assessment and management of a seizing child
Body weight estimation and appropriate paediatric emergency drug dosing
Common emergencies encountered in various subspecialties
Minor trauma, wounds and burns
Assessment and first aid of bruises, simple wounds and minor burns and indications for surgical referral
Indications for tetanus prophylaxis
Management of minor head injuries, including indications for neuroimaging
Toxicology
General approach to drug overdose
Management of paracetamol poisoning, including subacute, chronic and supratherapeutic poisoning
Orthopaedic problems
Approach to a limping child
Recognising radiographic features of fractures
Recognising the limitation of simple X-ray in children
Desirable skills
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Procedural analgesia
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Use of Broselow tape
Higher Training
Emergency room paediatrics
Foreign bodies in ear, nose and throat
Multidisciplinary collaboration in resuscitating and stabilizing a critically ill child
Indications for PICU support and facilitate transfer
Intra-hospital and inter-hospital transfer of a critically ill child
Risk assessment of Brief resolved unexplained event (BRUE)
Understand the risk factors of sudden expected death in infancy
Minor trauma, wounds and burns
Management of extravasation injuries
Recognition and management of non-accidental injuries
Toxicology
Recognition and management of various toxidromes
Collaboration with external toxicology resources (e.g. Poison Information Centre, Emergency Department)
Understand the role and limitations of point-of-care and laboratory-based toxicology tests
Risk assessment and indications for referral for advanced support (e.g. PICU support, renal replacement or ECMO)
Be aware of medications that are life-threatening even when ingested in small amount accidentally by small children (e.g. tricyclic antidepressants, anti-arrhythmic drugs, opioids, clozapine, antimalarials , beta blockers, calcium channel blockers, theophylline, oral hypoglycaemics
Orthopaedic problems
Identifying fractures suggestive of non-accidental injury
Differentiating pathological fractures and initiating appropriate workup and referrals
Ophthalmological problems
Acute red eye
Acute conjunctivitis
Periorbital and orbital cellulitis
Desirable skills
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Wound management including local anaesthetics administration, irrigation and simple sutures
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Rapid sequence induction and emergency intubation in children population