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Pediatrics

Rotation Responsibilities

  1. There will be two blocks of pediatrics in the first year and one block of in-patient pediatrics in the second and third years.  The Pediatric team will consist of two or three Family Medicine Residents.
  2. First year residents on pediatrics have the primary responsibility for providing patient care in both the Well-Baby Nursery, and pediatric floor.  
  3. Pediatric Floor Responsibilities:
    • The first year resident is responsible for seeing all medical pediatric admissions to the floor on weekdays from 8:00 a.m. to 5:00 p.m., (and Saturday and Sunday all day) from private attendings, CHOP patients, and Chief's Service patients.  It is expected that the first year resident will write a complete History and Physical examination, develop an assessment and a management plan to be reviewed with the patient's attending physician and an upper year resident when available.  The resident is expected to make daily patient rounds, write a daily progress note, and appropriate orders in consultation with his/her supervising resident and the patient's attending physician.
    • Family bedside rounds will be made daily with the CHOP attending and nurses at 9:30 (10:30 on NNS days) to discuss all patients on the Pediatric Inpatient Service.  The residents are expected to know each of the patients on the floor so that they may be presented to the CHOP attending and discussed for teaching purposes.
    • The residents may also follow any pediatric surgery patients who have consulted of CHOP.  Any major changes made on these patients should be relayed back to the surgeon and/or their residents.
  4. Emergency Trauma Center Responsibilities:
    • The residents on pediatrics will assist the ETC physicians with the evaluation and stabilization of critically ill pediatric patients in the Emergency Trauma Center and will expedite admission to Abington Memorial Hospital or transfer to another institution when indicated.  Residents are also expected to attend any Pediatric traumas to assist the Trauma Team as needed.  These residents will not be available for performing routine evaluations of non-critically ill patients in the Emergency Trauma Center.  The Pediatric resident will become involved in the care of non-critically ill patients only after the decision to admit has been determined by the attending physician or at the discretion of the CHOP attending.
  5. Residents are encouraged, when appropriate, to refer Chief's Service patients to the Family Medicine Center (AFM) for well childcare after discharge from the nursery and the pediatric floor.
  6. Residents on pediatrics will not take overnight call.  Weekday call will be covered by a night float system.  Call responsibilities will include covering the pediatric floor for medical problems and all pediatric medical admissions, as well as assisting at all problem deliveries and cesarean-sections as described above.  The resident will also be available to evaluate problems that develop in the Newborn Well Nursery.

    Sign out is 5:00 p.m. each night.  Formal sign out sheets need to be filled out for each patient on 1 Buerger (1H).  The covering pediatric team will return at 7:00 a.m. the next morning for sign out.  The upper year resident on Family Medicine call is the backup for the pediatrics resident.  Questions or problems should be directed to this resident.  Specific questions or problems on patients should be directed to the patient's attending physician.  Abnormal laboratory values or changes in patient’s clinical status should be relayed to the attending physician immediately.  If the attending cannot be reached, the resident should contact the upper year resident on Family Medicine Call.

    The administration of insulin doses, racemic epinephrine, or increased use of nebulizer therapy should be relayed to the CHOP attending for guidance.
  7. Weekend call will be covered by an ectopic Family Medicine resident.  Call will begin at 5:00 p.m. on Friday and conclude at 7:00 a.m. on Saturday.  Call will resume Saturday evening at 5:00 p.m. and conclude at 7:00 a.m. on Sunday.  The resident will return at 5:00 p.m. Sunday and conclude call at 7:00 a.m. Monday.  The resident will then be free from any responsibilities for the remainder of the day Monday.  Saturday and Sunday days from 7:00 a.m. to 5:00 p.m. will be covered by a resident on the inpatient pediatric team.  Residents on pediatrics will not average more than 6 days of work per week.
  8. The first year resident on pediatrics will have office hours in the Family Medicine Center one half day per week.  When there is an upper year supervising resident, that resident will cover the floor during the intern's absence. When the entire pediatric team is not in the hospital, the covering resident should be identified to the hospital operator, the Delivery Room, the Nursery, and the ETC.
  9. Weekend Chief’s Newborn responsibilities include:  Rounding on the newborns prior to 7:00 a.m. sign out, if no nurse practitioner coverage is available for the weekend.  It is the Friday night on call resident’s responsibility to see babies Saturday morning, prior to signing out on 1 Highland.  It is the Saturday night on call resident’s responsibility to see babies Sunday morning, prior to signing out on 1 Highland.  Monday morning newborns are seen by the daytime peds team. Other responsibilities include Nursery emergencies or c. sections after the nurse practitioner has gone home for the day, typically at 4:00 p.m.  It is essential to contact the nurse practitioner for an update prior to 4:00 p.m.
  10. The supervising pediatric resident will have office hours one half day per week in the Family Medicine Center.
  11. Peds residents respond to Pediatric Codes (Code 15) and pediatric trauma.

Lectures – 7:30 am

Wednesday – Dr. Russell; Thursday – Dr. Shapiro; Friday – Peds Attending/Dr. Russell (Selected Fridays)