Featuring:

• Cheryl Hirst, CCPA - Manitoba PA Graduate, Paediatric Hospitalist PA, Winnipeg, MB

• Jordan Levinter, CCPA - UofT PA Grad, Paediatric Emergency Medicine PA, Toronto SickKids Hospital

What is Paediatric Emergency Medicine? (PEM)

The Pediatric Emergency Department (PED), a specialized section within a hospital or medical facility, is dedicated to providing immediate care to children and adolescents suffering from acute illness or injury. Tailored specifically to meet the unique needs of younger patients, this area prioritizes rapid assessment and treatment in a child-friendly environment designed to ease the fears and anxieties of both children and their families. Pediatric Emergency Medicine as a specialty focuses on the prompt diagnosis and management of unforeseen illnesses or injuries in the pediatric population, encompassing a wide range of conditions from minor injuries to life-threatening situations.

Key characteristics of Pediatric Emergency Medicine and the Pediatric Emergency Department include:

• Child-Centric Care: The PED is equipped with medical equipment and facilities specifically designed for children of all ages, from newborns to teenagers, ensuring that care is age-appropriate and sensitive to the developmental needs of children.

• Triage: Upon arrival, children are assessed through a pediatric-specific triage process that prioritizes their care based on the severity of their condition. This process is critical in ensuring that the most urgent cases receive immediate attention.

• Multidisciplinary Team: Pediatric Emergency Medicine involves a collaborative approach, with pediatric emergency physicians, physician assistants, nurse practitioners, pediatric nurses, child life specialists, social workers, and other healthcare professionals working together. This team is specially trained to provide compassionate and effective care to children and support to their families.

• Acute and Urgent Care: The focus is on the rapid assessment, stabilization, and treatment of acute medical conditions and injuries in children. This may involve everything from providing comfort and pain relief to performing life-saving procedures and interventions.

• Family-Centred Communication: Recognizing the importance of family in a child's recovery, healthcare providers in pediatric emergency care place a strong emphasis on clear, compassionate communication with both the child and their family members, explaining care plans and procedures in an understandable way.

• Follow-up and Coordination of Care: After initial treatment, children may be discharged with recommendations for follow-up care with their primary pediatrician or referred to pediatric specialists for further evaluation and treatment. If necessary, children might also be admitted to the hospital for ongoing care.

Pediatric Emergency Medicine requires not only a broad knowledge of pediatric health conditions but also a high level of expertise in managing the emotional and psychological needs of young patients and their families. PAs must be skilled in quickly diagnosing and treating a wide array of conditions, all while maintaining a calm, reassuring presence. The unpredictable and often high-stress environment of the Pediatric Emergency Department demands resilience, patience, and the ability to communicate effectively with children at different developmental stages, making this specialty both challenging and rewarding.

What is Paediatric Internal Medicine?

Pediatric Inpatient Medicine focuses on the care of children and adolescents who are admitted to the hospital for treatment of acute or chronic illnesses, injuries, or for surgical procedures. This specialized field is dedicated to providing comprehensive and continuous care for hospitalized young patients, addressing their medical needs in a setting that is attuned to the unique aspects of pediatric health and development.

Child and Family-Centric Care: Inpatient settings are designed with the comfort and well-being of children in mind, offering a supportive environment that reduces stress and anxiety for both the patient and their family. Care teams strive to involve families in the care process, recognizing their integral role in the child’s health and recovery.

Key characteristics of Pediatric Inpatient Medicine include:

• Comprehensive Multidisciplinary Team: Pediatric Inpatient Medicine involves a collaborative approach to care, with pediatricians, physician assistants, nurse practitioners, pediatric nurses, specialists (such as pediatric surgeons, cardiologists, oncologists), nutritionists, pharmacists, child life specialists, and social workers working together. This team is specialized in addressing the physical, emotional, and developmental needs of hospitalized children.

• Continuity of Care: From admission to discharge, pediatric inpatient teams provide continuous monitoring and treatment of hospitalized children. This includes not only the management of their current health issues but also anticipatory guidance and planning for after-hospital care.

• Acute and Chronic Condition Management: The focus is on the comprehensive treatment of a wide range of conditions that require hospitalization, from acute illnesses and injuries to the management of complex chronic conditions. This encompasses both medical and surgical care, as well as the coordination of care among various specialists.

• Family Education and Support: Recognizing the importance of family in a child’s recovery, pediatric inpatient care includes significant emphasis on educating families about their child’s condition, treatment plans, and care needs after discharge. Support services may also be provided to help families cope with the stress of hospitalization and illness.

• Transition of Care: Effective pediatric inpatient care includes planning for the transition from hospital to home or to another level of care, ensuring continuity and coordination of care post-discharge. This may involve setting up follow-up appointments, coordinating with primary care pediatricians and specialists, and arranging for home health care or rehabilitation services as needed.