Peds EM fellowship and adult ED rotations

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igcgnerd

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I was curious as to why Peds EM fellowships require adult ED rotations. Do peds trained guys/ gals frequently find themselves treating adults in the ED in the community?

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I was curious as to why Peds EM fellowships require adult ED rotations. Do peds trained guys/ gals frequently find themselves treating adults in the ED in the community?

A couple of reasons. In general if you do peds--> EM fellowship, then you'll be seeing kids almost all the time. But any peds ED is bound by EMTALA and therefore you really have to be able to take the first steps to stabilize anyone who walks in regardless of age. We'd have a few adults get mixed up and walk in with chest pain or stoke like symptoms.

Secondly, the adult EM folks often have a different differential and disease experience than we do in peds. We rarely see COPD, and often don't think of things like MI or even PE. Getting a few months with guys who see these things daily really broadens our experience and way of thinking.
 
I was curious as to why Peds EM fellowships require adult ED rotations. Do peds trained guys/ gals frequently find themselves treating adults in the ED in the community?
I've been working in ERs for the past 5 years. For the past 2 I've been working in hospital that has its own pediatric ER next to the adult ER( working 90% of the time in the peds ER myself). 3( can be squeezed to 4) adult pods and 1 peds pod staffed every day. Often there is a lot of pressure on the Peds docs to take routine, or less acute adult patients when they are really slammed. Think lacs or ear pain or something. Now the department as a whole has made a policy that they can take any patient from 18-20 as long as its not a psych or +HCG without asking the Peds ED attending first.

The two most recent ones that come to mind were a 20yo new onset DM and a 19 with a prior CT that confirmed an appy that they werent too happy about. Actually i think we had a 19 year old chest pain the other day too. I had the EKG quick but he still didnt get the super speedy lab draws that their so acustomed to getting in the adult ED. Its definitely a different mindset, in a perfect world it wouldnt happen. but it does.
 
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