Knowledge/Skills:
ASTHMA
Demonstrate*
knowledge/understanding of:
Demonstrate
these skills/abilities:
History
·
Assessment
of asthma severity, asthma control and patient’s wheezing triggers
·
Appropriateness
of current home asthma regimen in relation to asthma control
·
Comorbidities
that may influence asthma control and
asthma exacerbation frequency
·
Perform
a focused asthma history
Physical
Exam
·
Pulmonary
findings that define chronic stable asthma and an asthma exacerbation
·
Pertinent
positives and negatives on non-pulmonary exam in patient with asthma
·
Perform
a focused asthma physical exam
Differential
diagnosis
·
Know
additional causes of wheezing in the pediatric patient (infant, toddler,
school age)
·
Know
additional causes of respiratory distress in the pediatric patient (infant,
toddler, school age)
·
Develop
a diagnostic plan to evaluate a pediatric patient with new-onset wheezing
Diagnostic
approach
·
Indications
for chest radiograph in asthma
·
Indications
for Pulmonary Function Testing in asthma
·
Indications
for Bronchoscopy in asthma
·
Existence
of other biomarkers for asthma diagnosis and management
·
Identify
chest radiograph findings consistent with asthma
·
Distinguish
normal and obstructive ventilatory patterns on spirometry
Therapeutics
·
Pharmacotherapy
of asthma (beta-agonists, atrovent, inhaled and oral corticosteroids,
leukotriene modifiers)
·
Potential
changes in outpatient regimen to improve asthma control
Disposition
·
Indications
for changing outpatient asthma regimen
·
Frequency
of follow-up required based on patient’s level of asthma severity and control
·
Design
an asthma action plan
Prevention
·
Preventive
home therapies
·
Potentially
modifiable environmental triggers
·
Resources
available to families for asthma education
CHRONIC RESPIRATORY FAILURE
Demonstrate*
knowledge/understanding of:
Demonstrate
these skills/abilities:
History
·
Assessment
of respiratory failure
·
Appropriateness
of current home chronic respiratory support
·
Pathophysiology
that mandates chronic respiratory support in each patient
· Comorbidities that may impair ventilation
· Risk factors for increased susceptibility to respiratory
infections in patients with chronic respiratory support
·
Perform a
focused history in a patient requiring chronic respiratory support
Physical Exam
·
Important
pulmonary findings in a patient
requiring chronic respiratory support
·
Pertinent
positives and negatives on non-pulmonary exam
·
Anatomic and
physiologic limitations that contribute to respiratory failure
·
Perform a
focused physical exam in a patient requiring chronic respiratory support
·
Recognize
the presentation of acute on chronic respiratory failure
Differential
diagnosis
·
Know causes
of respiratory failure in the
pediatric patient
·
Know causes
of respiratory distress in the pediatric patient
· Develop a diagnostic plan to evaluate a pediatric
patient with chronic respiratory failure in respiratory distress
Diagnostic approach
·
Indications
for a blood gas in a patient with
chronic respiratory failure
· Indications for chest radiograph in a patient with chronic respiratory failure
· Indications for Bronchoscopy in a patient with chronic respiratory failure
·
Interpret a
blood gas in a patient with chronic
respiratory failure
· Interpret a blood gas in a patient with acute respiratory failure
·
Interpret
chest radiograph findings in a patient with respiratory failure
Therapeutics
·
Pharmacotherapy
of pneumonia in a hospitalized pediatric patient with chronic respiratory
failure
·
Indications
for changing a tracheostomy tube
·
Indications
for initiating non-invasive respiratory support
·
Indications
for initiating or adjusting mechanical ventilation settings
·
Indications
for transfer to PICU
·
Select
antibiotic regimen for a patient with pneumonia and chronic respiratory
failure
·
Perform a
tracheostomy tube change
·
Adjust
ventilator settings based on patient comfort, oxygenation and ventilation
status
Disposition
·
Indications
for admitting a patient with chronic respiratory failure
· Discharge criteria for a
patient with chronic respiratory failure
· Work with a multidisciplinary team to arrange for the
safe discharge of the patient with chronic care needs to the home environment
Prevention
·
Preventive
home regimen
·
Resources
available to families for children with chronic care needs
· Understand basic self-management principles for chronic
disease
CYSTIC FIBROSIS
Demonstrate*
knowledge/understanding of:
Demonstrate
these skills/abilities:
History
·
Assessment
of severity of CF lung disease
·
Triggers for
a CF pulmonary exacerbation
·
Comorbidities
that may increase CF pulmonary exacerbation frequency
·
Perform a focused
CF history
Physical Exam
·
Pulmonary
findings in a patient with a CF pulmonary exacerbation
·
Abdominal
findings in a patient with Distal Intestinal Obstruction Syndrome
·
Pertinent
positives and negatives of non-pulmonary exam in patient with CF
·
Signs of respiratory
failure in CF
·
Perform a
focused CF physical exam
·
Recognize
severity of presentation of pulmonary exacerbation of CF in relation to vital
signs and patient appearance
Differential
diagnosis
·
Know causes
of crackles and tachypnea in the pediatric patient
·
Know causes
of respiratory distress in the pediatric patient
·
Understand
causes of abdominal pain in a patient with CF
Diagnostic approach
·
Indications
for a blood gas
·
Indications
for a chest radiograph
·
Indications
for a KUB
·
Indications
for Pulmonary Function Testing
·
Indications
for Bronchoscopy
·
Interpret a blood
gas in patient with CF
·
Demonstrate
chest radiograph findings consistent with CF
·
Differentiate
obstructive from non-obstructive KUB findings
· Interpret a Pulmonary Function Test
Therapeutics
·
Acute
therapy of a CF pulmonary exacerbation
· Acute therapy of Distal Intestinal Obstruction Syndrome
·
Indications
for BiPAP support in CF
·
Indications
for intubation and ventilation in CF
Disposition
·
Indications
for admitting a patient with a CF pulmonary exacerbation
· Indications for admitting a patient with Distal
Intestinal Obstruction Syndrome
· Indications for discharge in a patient with a CF
pulmonary exacerbation
· Indications for discharge in a patient with a Distal
Intestinal Obstruction Syndrome
Prevention
·
Understand
rigor and details of preventive home airway clearance regimen
· Understand basic self-management principles for chronic
disease
NEUROMUSCULAR DISEASE
Demonstrate*
knowledge/understanding of:
Demonstrate
these skills/abilities:
History
·
Assessment
of respiratory status
·
Triggers for
acute respiratory failure in a patient with neuromuscular weakness
·
Comorbidities
that may increase pneumonia risk
·
Perform a
focused history in a patient with neuromuscular weakness
Physical Exam
·
Pulmonary
findings in a patient with
neuromuscular weakness
·
Pertinent
positives and negatives of non-pulmonary exam in patient neuromuscular weakness
·
Signs of
respiratory failure in a patient with neuromuscular weakness
·
Perform a
focused physical exam in a patient
with neuromuscular weakness
·
Recognize
severity of presentation of acute respiratory decompensation in a patient
with neuromuscular weakness
Differential
diagnosis
·
Know
additional causes a weakened cough in the pediatric patient
· Know additional causes recurrent pneumonia in the
pediatric patient
·
Know
additional causes of respiratory distress in the pediatric patient
· Develop a plan to distinguish between pulmonary and
non-pulmonary causes of respiratory distress in a patient with neuromuscular
weakness
Diagnostic approach
· Indications for a blood gas in a patient with neuromuscular weakness
· Indications for a chest radiograph in a patient with neuromuscular weakness
· Indications for Pulmonary Function Testing in a patient with neuromuscular weakness
·
Interpret a
blood gas in a patient with neuromuscular weakness
·
Demonstrate
common chest radiograph findings in a patient with neuromuscular weakness
· Interpret a Pulmonary Function Test in a patient with
neuromuscular weakness
Therapeutics
· Empiric therapy of recurrent pneumonia in a patient with
neuromuscular weakness
· Indications for BiPAP support in a patient with neuromuscular weakness
· Indications for cough assist support in a patient with
neuromuscular weakness
·
Indications
for intubation and ventilation
· Evaluate the effectiveness of non-invasive ventilation
and cough assist support in a patient with neuromuscular weakness
Disposition
·
Indications
for admitting a patient with neuromuscular weakness and respiratory illness
· Indications for discharge in a patient with
neuromuscular weakness and respiratory illness
Prevention
·
Preventative
home cough assist regimen
·
Resources
available to families for children with chronic care needs
· Understand basic self-management principles for chronic
disease
Obstructive Sleep Apnea and
other Sleep Related Disorders
Demonstrate* knowledge/understanding of:
Demonstrate these skills/abilities:
History
· Assessment of sleep
symptoms, severity and triggers, sleep habits
· Appropriateness
of current home treatment or management
· Comorbidities
that may influence sleep symptoms or sleep disorders
· Perform a
focused Sleep history
Physical Exam
· Physical findings
that may suggest or be associated to obstructive or central sleep apnea,
hypoventilation, or insomnia.
· Pertinent
positives and negatives on non-pulmonary exam in patient with sleep
disorders.
· Perform a
focused sleep physical exam
Differential diagnosis
· Know additional
causes of sleep maintenance difficulty, or noisy breathing in the pediatric
patient (infant, toddler, school age)
· Know additional
causes of or excessive daytime sleepiness, excessive fatigue, morning
headaches or other morning symptoms in the pediatric patient (infant,
toddler, school age)
· Develop a
diagnostic plan to evaluate a pediatric patient with sleep disorders, e.g., obstructive
sleep apnea and restless leg syndrome
·
Develop differential
diagnosis for sleep related symptoms and a plan for further evaluation
Diagnostic approach
· Indications for
polysomnography (PSG)
· Indications for
titration PSG
· Indications for
overnight saturation study
· Indications for
Airway evaluation in patients with OSA
· Identify
polysomnography findings consistent with sleep apnea
· Distinguish
normal and abnormal findings on a sleep study
Therapeutics
· Pharmacotherapy of
sleep disorders and medications to avoid
· Potential
changes in outpatient regimen to improve sleep
·
Indication and criteria for referrals
to other subspecialties (sleep psychology, neurology) to address comorbid
conditions that impact sleep.
Disposition
· Follow-up on
patient with sleep disorders
Prevention
· Preventive home
management and safety measures
· Potentially
modifiable environmental triggers
· Disorders caused by untreated sleep apnea