EM Bootcamp CME credit value

[brooks23]

Hi Everyone, 

 

I am a brand spanking new PA and was sent to bootcamp in Vegas this week. I understand that it qualifies as category 1 CME, but am unsure how many credits it qualifies for. The course was roughly 26-27 hours long. Has anyone been to this, or does anyone have any insight for me? I want to make sure I log the appropriate amount of credits. 

 

The certificate doesn't specify how many credits the course qualifies for. 

 

Thank you!

 

 

[roger777]

I think it said it was 36 credits.

 

I was there too and thought it was pretty good. It was excellent PANCE review for me if nothing else 10/5). Didn't realize it was going to be all PP, but I found that I could stay fully engaged for close to 90% of the time which is pretty good for me with straight PowerPoint (I never would have gotten through a +++PP PA program; EMT portion of medic school is last time I ever endure that).

 

Are you going to take the advanced one or know anyone who has?

 

Procedures course was full. YOu didn't take it did you?

 

I am glad that I took it at this stage though and not 2-3 years in.

 

There were a ton of NPs there. They are coming! LOL.

 

Probably like 60% NPs, 30% PAs and 10% physicians. Does that sound about right to you?

 

On that note, I have been having a little discussion with some classmates about what they said regarding pediatric IVs.

 

For the rest of the board, essentially what they said was pretty much don't give them in the ER as they are only indicated for severe dehydration whereas nearly all non-neglected patients in the US are either mildly or moderately dehydrated. The standards for severe dehydration according to their table is obtundation, cap refill >4 secs, cool limbs, parched cracked mucus membranes, very sunken eyes, ++tachycardia, absent tears, hypotension in all positions). They said if they can't hold anything down, suppress with Zofran and everybody gets a sippy diet (5 ml q5 min). They said a moderately dehydrated kid (sunken eyes, ortho HypoTN, tachycardia, lethargic) of 45 lbs is probably down about 1.2L and the goal would be to make this up orally over 4 hrs.  They said to warn parents about over-hydration as this is common. Always get a finger stick.

 

I was really surprised by this and it goes against the experiences of many of my friends with kids and what I saw in the ER.

 

Would any anyone here not do an IV on a kid with sunken eyes, thready pulse and dry mucous membranes?

 

 

 

 

[south]

 

 

On that note, I have been having a little discussion with some classmates about what they said regarding pediatric IVs.

 

For the rest of the board, essentially what they said was pretty much don't give them in the ER as they are only indicated for severe dehydration whereas nearly all non-neglected patients in the US are either mildly or moderately dehydrated. The standards for severe dehydration according to their table is obtundation, cap refill >4 secs, cool limbs, parched cracked mucus membranes, very sunken eyes, ++tachycardia, absent tears, hypotension in all positions). They said if they can't hold anything down, suppress with Zofran and everybody gets a sippy diet (5 ml q5 min). They said a moderately dehydrated kid (sunken eyes, ortho HypoTN, tachycardia, lethargic) of 45 lbs is probably down about 1.2L and the goal would be to make this up orally over 4 hrs.  They said to warn parents about over-hydration as this is common. Always get a finger stick.

 

I was really surprised by this and it goes against the experiences of many of my friends with kids and what I saw in the ER.

 

Would any anyone here not do an IV on a kid with sunken eyes, thready pulse and dry mucous membranes?

 

What?  No.  Why?  By the time they finish half that sippy diet, they could be discharged and back at home, sleeping, with normal vitals and full fluids on board, not sitting in some hospital bed with clinical signs of dehydration and stress on the systems.  Not to mention taking up a bed space...

 

Over-hydration?  Fairly hard to do with someone who's dehydrated and has normal kidney function; you gotta be going out of your way...

 

My Peds ER experience was pre-PA, but I think if you kept an otherwise healthy, clinically dry barfer for 4 hours sipping on a cup you might get some pretty carefully worded comments, for any of these reasons.

[roger777]

Here are the relevant slides with my notes. Speaker was a boarded EM MD

 

https://drive.google.com/open?id=0B8AdpH2iaQ9oejF1bTdYRDBQXzg

 

The other inconsistency I noticed is that the sippy technique is only 60ml/hr while the requirement for that 45 lb moderately dehydrated pt would be 300ml/hr