PED 9207

Southeast Campus

Pediatric Critical Care Medicine

Location of Elective: MeritCare Children’s Hospital-PICU

Preceptor(s): Waldemar Storm, M.D.

Vytautas Sapiega, M.D.

Period(s) offered and number of students per period: All periods, 1 per period

Purpose: To gain clinical experience in the care of critically ill children.

Objectives: Following successful completion of this elective, the student will be able to:

1. Demonstrate an understanding of concepts of circulatory perfusion, cardiac output, oxygen delivery, oxygen consumption and cellular energy metabolism, and understand the role of derangements of these functions in critical illness and injury.

2. Recognize signs and symptoms of respiratory failure, circulatory failure, shock, sepsis, and seizures. Understand the immediate interventions to stabilize children with such life threatening conditions. In particular, understand and appreciate the role of airway management, IV fluid therapy, and nutrition in pediatric critical illness. Understand basic trauma management. Evaluate coma.

3. Describe appropriate diagnostic evaluation of children and these conditions after being stabilized.

4. Demonstrate understanding of the multidisciplinary nature of pediatric critical care. Show ability to interact with multiple physicians, surgeons, other specialists, and ancillary personnel such as respiratory therapists, nurses, social workers, and clergy. Understand the intensivist’s role as coordinator of total patient care.

5. Explain the relationship of molecular biology to the care of critically ill patients in such areas as tissue oxygenation, ARDS, sepsis, and multiple organ failure syndrome.

6. Apply techniques of physiologic monitoring to the management of the critically ill child.

7. Demonstrate awareness and understanding of the ways by which children and their families cope with serious illness and injury.

Instructional Activities: During this elective, students will be involved in/experience:

1. Daily patient rounds on assigned patients in which student is responsible for forming appropriate

assessment and care plans.

2. Daily discussions of specific patient problems based on the reading and instructional assignments given to the student by the preceptor.

3. Common procedures performed in the setting of the pediatric intensive care unit under the close supervision of the preceptor.

4. The calculation of enteral and parenteral nutritional requirements of the critically ill child.

5. Weekly Pediatric Grand Rounds.

6. A team approach (including family involvement) to the management of the ill child.

7. Patient care presentation by student to the preceptors.

Criteria for Grading: During and following this elective, the preceptor will:

1. Submit a summative evaluation on a form approved by CEC.

2. Assess the quality of patient evaluations and daily notes.

3. Assess the quality of performance of the instructed procedures.

4. Assess the quality of oral and written presentations to the preceptor of assigned readings.