Abstract 438
Background: Residency PICU guidelines exist but long term proof of impact does not. Objective: Correlate PICU curriculum and GP needs. Design: During first year post residency, 11 question survey mailed to PICU residents from 1994-1996. Results: Response 14/35 (40%); 8/14 (57%) general practice, 4/14 (29%) fellowship, 2/14 (14%) chief residents. Ranking comfort with critically ill children on scale 1-10 (10=best), 92% ranked >6 (mode 8). During first year post residency, interventions taught during PICU rotation were infrequently encountered monthly: airway obstruction, bag-mask ventilation, septic shock, respiratory failure, intubation, ventilator support, chest tube placement, seizures, ICP control, overdoses, multiple organ dysfunction, airway foreign bodies, cardiopulmonary arrest, coagulation problems, interpreting EKGs, vascular access, transcutaneous pacing, cardiovesion, defibrillation, giving caregivers bad news, order Do Not Attempt Resuscitation. In terms of teaching delivered per teaching effort expended, there is a 20% weekly, 30% monthly and 70 % yearly increased likelihood of GP utilizing information from 4 mock codes than from 8 specific critical care topic lectures combined. Conclusions: 1 year after residency, surveyed GPs report high comfort to recognize and stabilize critically ill children, but infrequently employ skills unique to PICU training. Mock codes rather than lectures may better simultaneously reinforce those critical care skills needed in general pediatric practice.
