Table 2.

Syllabus.

Module 1: Pediatric Airway Management ABCs Manual airway management Anatomic considerations Technique for jaw thrust and chin lift Management of choking Oxygen delivery systems Nasal cannula Non-rebreather mask CPAP/bubble CPAP Ambu bag Airway adjuncts Nasopharyngeal airway Oropharyngeal airway Intubation and indications Rapid Sequence Intubation (RSI) Medications and dosing Resource specific considerations Interactive case presentation 3-year-old female with foreign body in airway Mannequin Simulations 7-year-old female with respiratory distress due to pneumonia 5-year-old male with airway compromise secondary to seizure activity Debriefing of Simulations

Module 2: Respiratory Distress in the Child Identify major differences between children and adults with respiratory distress Form a systematic initial evaluation of illness severity Review of physical exam findings in children with respiratory illness Interactive case presentations: upper versus lower airway findings Review of ancillary studies Interactive case presentations: common pediatric causes of respiratory distress and management Laryngotracheobronchitis Bacterial tracheitis Epiglottitis Complications of pharyngitis: peritonsillar abscess and retropharyngeal abscess Acute management of choking and foreign body aspiration Pneumonia and complicated pneumonia Bronchiolitis Asthma Anaphylaxis Review of commonly used medications and dosing Mannequin simulations: Laryngotracheobronchitis Asthma exacerbation Debriefing of simulations

Module 3: Pediatric Trauma: General Approach and Thoracic and Abdominal Trauma Local epidemiology Road traffic accidents Systematic approach: advanced traumatic life support Primary survey: airway, breathing, and circulation Shock Disability and exposure Secondary survey Overview of types of abdominal trauma Management of blunt abdominal trauma Liver and splenic lacerations and management Hollow viscera injury Use of imaging Overview of types of thoracic trauma Lung contusions Rib fractures Pneumothoraces—technique for needle decompression Hemothorax Esophageal injury Aortic injury Hemopericardium—technique for pericardiocentesis Tetanus prophylaxis Interactive case presentations 7-year-old male victim of road traffic accident with tension pneumothorax 10-year-old female, unresponsive, victim of road traffic accident 4-year-old male with blunt abdominal trauma Debriefing

Module 4: Pediatric Trauma Management: Head Trauma and Cervical Spine Review of the principles of trauma assessment ABCDE Initial survey Cervical spine injury Anatomic considerations Stabilization techniques Clearance Secondary survey Head trauma Physical exam findings Concussion, fracture, bleeds, and diffuse axonal injury Management of elevated intracranial pressure Interactive case presentations: 5-year-old male with head trauma 4-year-old male with low risk head trauma 12-year-old male with neck pain following road traffic accident 9-month-old male with altered mental status secondary to non-accidental trauma Discussion/questions

Module 5: Pediatric Sepsis and Shock Define sepsis and shock How to recognize shock quickly Distinguish between different types of shock Basic management strategies of shock Fluid resuscitation with and without severe malnutrition Use of vasopressor support Review of normal pediatric vital signs Review of potential lab abnormalities seen in shock Interactive case presentations: 6-month-old male with septic shock 7-month-old female with cardiogenic shock secondary to supraventricular tachycardia 9-year-old female with obstructive shock secondary to tension pneumothorax 6-year-old male with hypovolemic shock secondary to trauma Discussion/questions

Module 6: Endocrine Emergencies: Diabetic Ketoacidosis (DKA) and Adrenal Crisis Epidemiology of DKA in sub-Saharan Africa Pathophysiology of DKA Recognition and diagnosis of DKA Signs and symptoms Expected laboratory abnormalities Complications of DKA Emergency department management of DKA Adrenal insufficiency Pathophysiology and etiology of adrenal insufficiency Recognition and diagnosis of adrenal crisis Management of adrenal crisis Presentation of congenital adrenal hyperplasia Interactive case simulation: 6-year-old male with DKA Discussion/questions

Module 7: Altered Mental Status and Pediatric Toxicology A systematic approach to the pediatric patient with altered mental status Review of the differential diagnosis for altered mental status in the child Review of basic management of seizures in a pediatric patient Review of the common pediatric toxidromes and their management Mannequin simulation Simple febrile seizure Mannequin simulation Hypoglycemic seizure Debriefing of simulation cases

Module 8: Pediatric Orthopedic Emergencies Review of the differences between adult and pediatric musculoskeletal injuries Review of bone development, ossification centers, Salter-Harris fractures Review of basic approach to a fracture or musculoskeletal injury Interactive case presentations of common pediatric orthopedic injuries with x-rays on projector screen: Long bone fracture Compartment syndrome Fall onto outstretched hand Greenstick fracture Buckle fracture Radial head subluxation, “Nursemaid’s Elbow” Supracondylar fracture Clavicle fracture Toddler’s fracture Spiral femur fracture Fractures that require immediate orthopedic referral The child who refuses to bear weight on lower extremity Discussion/questions

Module 9: Pediatric Burn and Wound Management Background and epidemiology of pediatric burns Pathophysiology of burns Classification and management of burns Specific medications for burn management Additional considerations in burns: ABCDs Useful labs When to admit, discharge, or transfer patients Specific burn types Infection management Escharotomy Utilization of Parkland Formula for fluid management Principles of wound management Interactive case presentations with photographs of burns on projector First- through fourth-degree burns Discussion/questions

Module 10: Pediatric Advanced Life Support (PALS) Review of ABCD and overall approach Review of normal pediatric vital sign ranges by age Basic life support skills: giving breaths and doing compressions Review of important resuscitation medications and dosing Pediatric Cardiac Arrest Algorithm Reversible Causes of Cardiac Arrest (H’s and T’s) Ventricular fibrillation/Ventricular tachycardia/Asystole/Pulseless electrical activity Pediatric Bradycardia algorithm Common EKG findings Pediatric tachycardia algorithm Post-resuscitation care Mannequin simulations 3-year-old female found down (pulseless arrest) 5-year-old male with bradycardia Management of supraventricular tachycardia Debriefing of simulations