Pediatric Pearls

The June 15 track will review the management of acute COVID-related presentations including multi system inflammatory syndrome in children (MIS-C). The diagnosis and management of cardiac emergencies spanning the breadth and depth of pediatrics will be reviewed. Virtual pediatric emergency medicine will be reviewed including the indications and potential concerns surrounding patient safety. Trauma systems as they pertain to patients in rural and remote areas of Canada will be reviewed. June 16’s track will review the diagnosis and management of marijuana ingestions and overdoses along with cannabinoid hyperemesis syndrome patients. The 2020 Pediatric Advanced Life Support guidelines will be presented and critically reviewed. Pediatric POCUS cases will be presented illustrating the importance of its use. The management of pediatric pain in the emergency department will be reviewed.

Coming Soon.

Speakers
Tuesday June 15

Children and COVID: Pediatric and Critical Care in your ED

This presentation will summarize pediatric considerations in the management of children with COVID-19 infection and Multisystem Inflammatory Syndrome (MIS-C), including approaches to and strategies for evaluation, diagnosis and treatment.

Learning Objectives

Identify variations in the approach to resuscitation of pediatric patients with COVID-19.
Recognize the three primary presentations of MIS-C and differentiate from similarly presenting illnesses, including Kawasaki Disease and toxic shock syndrome (TSS).
Review a process and apply strategies for systematic evaluation of patients with possible MIS-C.
Discuss treatment options and priorities in the management of patients with MIS-C.
Utilize strategies to support MIS-C patients with hemodynamic instability.

Pearls

Presentation of COVID infection in children and MIS-C can overlap with common pediatric illnesses; timely diagnosis requires early recognition, high clinical suspicion and a systematic approach.
Positive pressure ventilation in children can be both lifesaving and done safely, and should not be withheld because of aerosol-generating concerns.
Patients with MIS-C can worsen quickly; healthcare providers must anticipate and prepare for rapid clinical deterioration.

Pediatric Cardiac Emergencies: Lessons Learned

Talk will centre on pediatric cardiac disease that can present at different ages. The tell tale signs that will separate the cardiac diagnosis from other causes of similar symptoms.

Learning Objectives

Neonatal Cardiac Disease not to be missed (Grey vs Blue)
Pediatric Myocarditis
Pediatric Myocardial Infarction

Pearls

Blue is bad – Sick neonate think cardiac
Not all SOB /Wheezing is Asthma.
Kids do have abnormal ECG’s that are pathological

Virtual Pediatric Emergency Medicine Care: Patient Safety Versus Patient Risk

To review indications for safe virtual care and potential high risk situations to consider

Learning Objectives

Understand indications for safe virtual care
Understand the mechanisms for safe care
Recognize the barriers for virtual care

Pearls

Virtual urgent care is patient centred
Virtual care can be safe
Virtual care may play an important role in the future of healthcare in Canada

Value of Rural and Remote Trauma Centers in Canadian Pediatric Trauma Systems

Canadian geography results in relative rurality of trauma systems with high dependence of rural and rumote centers in managing traumatic injuries in children to varying extents. We will discuss this in the context of knowledge and resource needs to enhance the roles of these vital centers in Canadian pediatric trauma systems

Learning Objectives

To understand the structure and function of trauma systems in Canada with a focus on pediatric major trauma
To appreciate the roles played by rural and remote hospitals in the management of pediatric trauma within trauma systems
To understand the structure and function of trauma systems in Canada with a focus on pediatric major trauma

Speakers
Wednesday June 16

Pediatric Marijuana: Lurking in the ED

The talk will run through a brief history of cannabis prohibition and its affect on radicalized communities, before reviewing medical issues for teenagers using cannabis regularly and unintentional ingestion of cannabis edibles by young children.

Learning Objectives

Provide a brief history of cannabis
Review social consequences of cannabis prohibition and legalization with a focus on racial disparity
Identify special issues for teens with respect to cannabis use
Review pediatric accidental ingestions of THC containing edibles

ALS Update 2020 – Has Anything Really Changed?

The talk today is to highlight changes in the American Heart Association, Paediatric Advanced Life Support (PALS) guidelines for 2020. We will also explore some of the reasons why this evidence change was made.

Learning Objectives

Review important updates in the 2020 PALS guidelines
Explore evidence leading to guideline changes

Pearls

For infants and children requiring ventilation, it is reasonable to give 1 breath every 2 to 3 seconds (20-30 breaths/min)
It is reasonable to used cuffed tubes when incubating infants and children.
When doing chest compressions try to administer epinephrine in less than 5 min from the start of chest compressions.

Pediatric POCUS – Presentations to Definitely Scan

Pearls
Use POCUS as a rule-in tool
Ensure you are aware of a specific clinical question when using POCUS

The Pediatric Pain Journey: From Triage to Discharge and Beyond

Brief resume of the CPS procedural pain statement including: Review of physical, psychological and pharmacological strategies; Discussion on prevention of procedural pain and tips to reduce moderate sedation -Review of interesting tools to assess pain in children -Considerations for adequate use of opioids -Importance of family inclusion in pain management in the ED and beyond

Learning Objectives

To review the optimal management of pediatric pain in the Emergency Department
To discuss interresting physical and psychological strategies
To evaluate when pharmacological strategies are appropriate

Pearls

Do not underestimate the power of the NON pharmacotherapy
Use sedation agents and opioids appropriately
Importance of family centered care