vanessa thomas md - em providers knowledge management tropical diseases

Pediatrics

EM Providers’ Knowledge and Management of

Pediatric Tropical DiseasesVanessa Thomas, M.D.

Pediatric Emergency Medicine Fellow

xxx00.#####.ppt 05/02/23 10:23 PMPediatrics Pediatrics

Survey Needs AssessmentObjectives:

- Knowledge- Comfort- Practice patterns

Components:- Demographics- Symptom based evaluations- Case vignettes


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)


**

Comfort Level: - Low 62%- Medium 34%- High 4%

Knowledge Assessment


Travel History Questioning Based on Symptom


Next Steps: Clinical Algorithms


Maculopapular

Yes

No

Rash

Rash

Region of travel

Exposures Mosquitoes

Latin America

Rash

Headache

Petechiae

Joint pain

Fever

Cough

Symptoms:


Dengue Fever(Arbovirus)

Incubation: 3-14 daysTransmission: mosquitoes

Symptoms: Headache, fever, bone/joint pain, retro-orbital pain, leukopenia, petechiaSevere Dengue: Vomiting, abdominal pain, mucosal bleeding, shockComplications: Myocarditis, pancreatitis, hepatitis, neuroinvasive

Diagnosis: Antibody testing or PCR

Treatment: Fluid support, avoid NSAIDs

vanessa thomas md - em providers knowledge management tropical diseases

Healthcare