The resource is an online case-based lecture that encompasses frequently seen inpatient scenarios on a pediatric hematology-oncology ward, specifically, fever and neutropenia, tumor lysis syndrome, nausea and vomiting, and acute chest syndrome. The content is aimed at those who rotate on this inpatient service, including first-year pediatric hematology-oncology fellows as well as pediatric, medicine-pediatric, and family-practice residents. Medical students rotating on the service could also review this resource with guidance from residents or fellows. While none of the cases should be viewed as an exhaustive discussion of the topic, an effort has been made to focus on areas of frequent discussion (and occasional controversy) among inpatient hematology-oncology providers. The format is ideal for self-study or for teaching from a more senior member of the team (resident or fellow) who has previously looked through the cases. The cases should be used as a supplement to instruction already occurring from fellows and attendings. The resource has been used for teaching pediatric residents who are on their overnight shift on the pediatric-oncology hematology inpatient service at Seattle Children’s Hospital. Adjustments have been made to the resource to further cover areas of frequently asked questions. There has been an enthusiastic response to the format, and many of the residents and fourth-year medical students have requested that we continue with self-teaching. However, there has not been any attempt to confirm that this module improves learning outcomes.
By the end of this resource, learners should be able to:
- Obtain a thorough but focused history and workup of a pediatric patient with fever and neutropenia.
- Describe the rationale for frequently used antibiotics in the pediatric neutropenic population.
- Describe an appropriate response to the development of sepsis in a pediatric neutropenic patient.
- Assess and respond to tumor lysis lab values in a pediatric oncology patient.
- Describe the rationale for interventions and adjustments made to lower the risk of tumor lysis syndrome.
- Assess and respond to nausea and vomiting in a pediatric oncology patient.
- Identify the dosing and side effects of commonly used antiemetics in the pediatric population.
- Assess and respond to a sickle cell patient who develops acute chest syndrome.
- List the interventions for acute chest syndrome and the rationale for each intervention.
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