BHS education resource site. RCH orthopaedic fracture guidelines Self-Directed learning package Learning Outcomes – treat patient with … Topic/presentation Workbook case SICK NEONATES Awareness of risk of kernicterus and why we treat jaundice; causes and initial investigations (early & late) & use of phototherapy incl awareness of guidelines Jaundice A bit yellow Awareness of risk factors for hypoglycaemia, why early screening & recognition is important; initial management Hypoglycaemia Drowsy, poor feed Neonatal sepsis and meningitis Infectious diseases Irritable neonate Neonatal resuscitation Attend childbirth Seizures Post PAEDIATRICS Development Failure to thrive? Normal Post birth checks Baby check Respiratory Bronchiolitis & Asthma Infant with wheeze Cough and fever Gastroenteritis Assessment of dehydration Dehydration PO/NG/IV fluid therapy A child with nausea and vomiting Procedures Analgesia needed A post op patient Sedation Bloods and IV needed Rashes Not to miss + non blanching rash Seizures Neurological exam A child presents after first seizure Limping child Age related causes Child won’t weight bear Safe discharge Discharge planning Child protection Family violence Other topics relevant to paediatrics may be covered in the ED workbook Eg. Anaphylaxis, common fractures, and accidental poisonings. Snake bite. Feedback Complete the self-directed workbook and if it raises questions, ask your supervisor. Add interesting cases to your consults list in BOSSNET, to facilitate discussion. This ensures you do not need to keep lists with patient information, which if taken off site can result in privacy and confidentiality breaches
How will you establish rapport with mum and child? Eye contact, plain language, non-verbal cues, position yourself below child’s eye level What are your options or strategies for; Distraction methods? Examples – audiovisual, bubbles,… Analgesia? Examples – oral versus intranasal options Topical anaesthesia? Examples – including duration of onset, and offset Positioning of the patient? Sedation? Examples – intranasal midazolam More advanced options could be discussed for bigger procedures Who can help you? Rash A four year old boy presents to the ED after becoming suddenly unwell at his kindergarten. He was well in the morning, his siblings have recently had viral upper respiratory tract infections, and shortly after lunch he developed a fever, sore throat
• Responds appropriately to verbal and non-verbal cues 2. Physical examination skills • Performs a focused physical examination that is relevant and accurate • Explains to patient • Sensitive to patient’s comfort and modesty □ Competent □ Not yet competent 3. Communication skills • Develops rapport, trust and understanding with patient/family • Accurately conveys relevant information and explanations to patients/family and other health professionals • Develops a shared plan of care with patients/families and other health professionals • Effectively manages challenges such as obtaining informed consent, delivering bad news, addressing anger and misunderstanding □ Competent □ Not yet competent 4. Clinical judgment • Demonstrates effective clinical problem solving and judgement to address patient problems • Interprets available data and integrates information to generate differential diagnoses and management plans □ Competent □ Not yet competent 5. Professionalism/ Consideration for patient • Exhibits honesty, integrity, compassion and respect • Participates effectively and appropriately in an interprofessional healthcare team • Appropriately manages conflicts of interest • Aware of own limitations □ Competent □ Not yet competent 6. Organisation/ efficiency • Sets priorities and manages time efficiently • Manages competing demands and stress • Appropriately manages supervision, resources and staff, ED access and flow □ Competent □ Not yet competent Overall performance □ Competent □ Not yet competent Assessor comments on candidate’s strengths and areas for improvement. Date: Clinical Problem: Assessment Criteria Descriptors Results 1. History taking • Elicits a history that is relevant, concise and accurate to patient’s context and preferences • Effectively uses appropriate questions • Responds appropriately to verbal and non-verbal cues □ Competent □ Not yet competent 2. Physical examination skills • Performs a focused physical examination that is relevant and accurate • Explains to patient • Sensitive to patient’s comfort and modesty □ Competent □ Not yet competent
3. Communication skills • Develops rapport, trust and understanding with patient/family • Accurately conveys relevant information and explanations to patients/family and other health professionals • Develops a shared plan of care with patients/families and other health professionals • Effectively manages challenges such as obtaining informed consent, delivering bad news, addressing and misunderstanding □ Competent □ Not yet competent 4. Clinical judgment • Demonstrates effective clinical problem solving and judgement to address patient problems • Interprets available data and integrates information to generate differential diagnoses and management plans □ Competent □ Not yet competent 5. Professionalism/ Consideration for patient • Exhibits honesty, integrity, compassion and respect • Participates effectively and appropriately in an interprofessional healthcare team • Appropriately manages conflicts of interest • Aware of own limitations □ Competent □ Not yet competent 6. Organisation/ efficiency • Sets priorities and manages time efficiently • Manages competing demands and stress • Appropriately manages supervision, resources and staff, ED access and flow □ Competent □ Not yet competent Overall performance □ Competent □ Not yet competent Assessor comments on candidate’s strengths and areas for improvement. Appendix - What does the Australian Curriculum Framework mean for junior doctors? The learning objectives above will reflect things that your supervisor expects you to have learnt during your term. The learning objectives above are linked to the Australian Curriculum Framework for junior medical doctors. This is provided below (), and it is evident that there is a lot of information so we have provided a shorter version here. We have also highlighted certain elements of the ACF which are particularly important or relevant to a paediatric term. Clinical Management Learning Resources Patient assessment