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Objectives: Emergency medicine (EM) trainees are expected to learn to provide acute care for patients of all ages. The American Council for Graduate Medical Education provides some guidance on topics related to caring for pediatric patients; however, education about pediatric topics varies across residency programs. The goal of this project was to develop a consensus curriculum for teaching pediatric emergency care.Methods: We recruited 13 physicians from six academic health centers to participate in a three-round electronic modified Delphi project. Participants were selected on the basis of expertise with both EM resident education and pediatric emergency care. The first modified Delphi survey asked participants to generate the core knowledge, skills, and experiences needed to prepare EM residents to effectively treat children in an acute care setting. The qualitative data from the first round was reformulated into a second-round questionnaire. During the second round, participants used rating scales to prioritize the curriculum content proposed during the first round. In round 3, participants were asked to make a determination about each curriculum topic using a three-point scale labeled required, optional, or not needed. Results:The first modified Delphi round yielded 400 knowledge topics, 206 clinical skills, and 44 specific types of experience residents need to prepare for acute pediatric patient care. These were narrowed to 153 topics, 84 skills, and 28 experiences through elimination of redundancy and two rounds of prioritization. The final lists contain topics classified by highly recommended, partially recommended, and not recommended. The partially recommended category is intended to help programs tailor their curriculum to the unique needs of their learners as well as account for variability between 3-and 4-year programs and the amount of time programs allocate to pediatric education. Conclusion:The modified Delphi process yielded the broad outline of a consensus core pediatric emergency care curriculum.E mergency medicine (EM) physicians acquire proficiency in the emergent management of all patients including pediatric patients during their training. Despite the growth of pediatric EM as a subspecialty, pediatric EM (PEM) subspecialists only care for 10% to 20% of the pediatric patients in the emergency setting across the United States.1 The remaining 80% to 90% of pediatric emergency care patients are cared for by EM physicians and/or general practice pediatricians.2-5 The Accreditation Council for Graduate Medical Education (ACGME) requires EM residents to have approximately 20% of their patient encounters with patients less than 18 years of age, including the critical care of infants and children.6 While time dedicated to pediatrics has increased in recent years, 7 concerns remain as to whether this allows sufficient experience to develop the mastery level competency for the EM physician to effectively care for children. 4,7 Although the type of clinical experiences available is beyond the...

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Lemierre syndrome is a disease that presents with oropharyngeal infection, sepsis, internal jugular vein thrombosis, and septic emboli with the Gram-negative organism Fusobacterium necrophorum cultured as the etiologic agent. Clindamycin, metronidazole and ampicillin-sulbactam are effective antibiotic treatments, although the length of treatment has not been firmly established. The syndrome is seen less frequently in the current age of antibiotics. It is important, however, that physicians be aware of the syndrome as initiation of prompt antibiotic therapy, including anaerobic coverage, is essential for avoiding morbidity and mortality. We describe a case of Lemierre syndrome.

We found no relationship between vitamin D deficiency and fracture risk in our study population.