1. Pediatric Emergency Medicine Roger M. Barkin, M.D

2. Pediatric Emergency Medicine US: conjoint specialty board reflecting the biology of emergency medicine and pediatrics. It’s history is relatively short, but its impact has been tremendous.

3. History 1933American Board of Pediatrics (AAP) 1968American College of Emergency Physicians (ACEP) 1976American Board of Emergency Medicine (primary board in 1989) 1980First PEM fellowship established in Philadelphia 1981Section of Pediatric Emergency Medicine of AAP 1984Task Force created by ACEP and AAP 1988Section of Pediatric Emergency Medicine of ACEP 1991Joint PEM sub-board established 1992 First PEM certification examination

4. Educational Program Fellowship training Residency training PALS and APLS Nursing and paramedic

5. Certification Prior certification in pediatrics or emergency medicine Two or three year fellowship

6. Clinical Settings - Hospital Emergency Department - Goals –Expedite Care –Quality of Care –Marketing –Community Service

7. Clinical Settings - Hospital Emergency Department - Requirements –Volume –Institutional philosophical & financial committment

8. Clinical Settings - Hospital Emergency Department - Settings –Pediatric specialized facility/area –Mixed use facility 30% of general ED population is pediatric –No differentiation

9. Clinical Settings - Hospital Emergency Department - Environment –Interior decorating –Toys –Play areas –Distractive therapy (videos/games)

10. Clinical Settings - Hospital Emergency Department - Personnel –Physicians –Nursing –Physician assistants/extenders –Laboratory –Radiology

11. Clinical Settings - Hospital Emergency Department - Equipment –Resuscitation –Standard Supplies

12. Clinical Settings - Hospital Emergency Department - Observation Units Educational Programs –PALS

13. Clinical Settings - PreHospital Equipment Personnel Training

14. Clinical Settings - In-patient Pediatric specialized facility Mixed-use facility “Hospital within a hospital”

15. Clinical Focus Protocols Analgesia and sedation Rapid sequence induction (RSI) Trauma Child abuse/neglect Special needs children

16. Equipment and Training Literature/Research

17. Education and Prevention