Dr. Vanessa Thomas presents her data from the AAP Section on Emergency Medicine PEM CRC survey competition winning survey.

1. Pediatrics
EM Providers’ Knowledge
and Management of
Pediatric Tropical Diseases
Vanessa Thomas, M.D.
Pediatric Emergency Medicine Fellow

2. Page 2
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Survey Needs Assessment
Objectives:
- Knowledge
- Comfort
- Practice patterns
Components:
- Demographics
- Symptom based evaluations
- Case vignettes

3. Page 3
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Factor N (% or median range)
Years practiced in EM 6 yrs (<1-15)
Level of training
PEM Attending
PEM Fellow
EM Resident
EM Attending
General Pediatrician
Combined PEM/EM Attending
222 (67%)
63 (19%)
19 (6%)
13 (4%)
8 (2%)
8 (2%)
Region of current practice
South
Midwest
West
Northeast
Canada
124 (37%)
77 (23%)
68 (20%)
60 (18%)
4 (2%)
Training demographics
Training outside United States
Tropical disease training
75 (22%)
44 (13%)
Number of tropical diseases
diagnosed past year
1 (0-10)
Malaria:
- More common diagnoses made
- Travel history not obtained in ED
- Not very ill on initial presentation
- Common presenting complaints
Typhoid Fever:
- Multiple visits to diagnose
- Negative blood culture
Dengue:
- Travel history not obtained in ED
Total 333 (SOEM 272, ACEP 155)

4. Page 4
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
*
*
Comfort Level:
- Low 62%
- Medium 34%
- High 4%
Knowledge Assessment

5. Page 5
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Travel History Questioning Based on Symptom

6. Page 6
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Next Steps:
Clinical Algorithms

7. Page 7
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Maculopapular
Yes
No
Rash
Rash
Region of travel
Exposures Mosquitoes
Latin America
Rash
Headache
Petechiae
Joint pain
Fever
Cough
Symptoms:

8. Page 8
xxx00.#####.ppt 10/24/16 02:29 AM
PediatricsPediatrics
Dengue Fever
(Arbovirus)
Incubation: 3-14 days
Transmission: mosquitoes
Symptoms: Headache, fever, bone/joint pain, retro-orbital
pain, leukopenia, petechia
Severe Dengue: Vomiting, abdominal pain, mucosal
bleeding, shock
Complications: Myocarditis, pancreatitis, hepatitis,
neuroinvasive
Diagnosis: Antibody testing or PCR
Treatment: Fluid support, avoid NSAIDs