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World J Crit Care Med. 2018 May 4;7(2):31-38. doi: 10.5492/wjccm.v7.i2.31. eCollection 2018 May 4.

Confidence level of pediatric trainees in management of shock states.

Author information

1
Department of Pediatric Critical Care, Children's Hospital of New Jersey, Newark Beth Israel Medical Center, Newark, NJ 07112, United States.
2
Department of Emergency Medicine, Children's National Health System, Washington, DC 20010, United States.
3
Department of Critical Care Medicine, George Washington University, Children's National Health System, Washington, DC 20010, United States.

Abstract

AIM:

To assess overall confidence level of trainees in assessing and treating shock, we sought to improve awareness of recurrent biases in clinical decision-making to help address appropriate educational interventions.

METHODS:

Pediatric trainees on a national listserv were offered the opportunity to complete an electronic survey anonymously. Four commonly occurring clinical scenarios were presented, and respondents were asked to choose whether or not they would give fluid, rank factors utilized in decision-making, and comment on confidence level in their decision.

RESULTS:

Pediatric trainees have a very low confidence level for assessment and treatment of shock. Highest confidence level is for initial assessment and treatment of shock involving American College of Critical Care Medicine/Pediatric Advanced Life Support recommendations. Children with preexisting cardiac comorbidities are at high risk of under-resuscitation.

CONCLUSION:

Pediatric trainees nationwide have low confidence in managing various shock states, and would benefit from guidance and teaching around certain common clinical situations.

KEYWORDS:

Central venous pressure; Decision-making; Fluid bolus; Medical education; Pediatric advanced life support guidelines; Shock

Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

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