McGill.CA / Department of Pediatrics / Education and Training / Postgraduate Medical Education / Competency-Based Medical Education

FOD 7: Performing basic pediatric procedures

Key Features

  • This EPA includes determining which procedures are necessary and appropriate to the situation.
  • Procedures include: bag valve mask ventilation; cardiopulmonary resuscitation (ventilation and massage, defibrillation in core); intraosseous injection; lumbar puncture in neonates and infants; changing tracheostomy tubes for obstruction or decannulation; needle thoracostomy in neonate.
  • Some procedures may be observed in a clinical or simulation setting, including Pediatric Advanced Life Support (PALS) or Neonatal Resuscitation Program (NRP) courses, and/or mock codes.

Assessment plan

Direct observation by supervisor

Use Form 2. Form collects information on:

  • Procedure: bag valve mask ventilation; cardiopulmonary resuscitation (ventilation and massage); changing tracheostomy tubes for obstruction or decannulation; intraosseous injection; lumbar puncture; needle thoracostomy
  • Setting: clinical; simulation
  • Age: neonate; infant; preschool; school age; adolescent

Collect 12 observations of achievement (those marked with an asterisk may be observed in simulation).

  • At least 4 bag valve mask ventilation in neonate/infant (no simulation), preschool* and school age/adolescent*
  • At least 2 cardiopulmonary resuscitation*
  • At least 1 changing tracheostomy tubes for obstruction or decannulation*
  • At least 2 intraosseous injection*
  • At least 2 lumbar punctures in neonates/infants
  • At least 1 needle thoracostomy in neonate* (clinical setting recommended, but simulation is acceptable)

CanMEDS milestones

  1. ME 3.2 Obtain and document informed consent, explaining the risks and rationale for a proposed procedure
  2. ME 3.4 Gather and/or manage the availability of appropriate instruments and materials
  3. ME 3.4 Position the patient appropriately
  4. ME 3.4 Demonstrate aseptic technique: skin preparation; draping; establishing and respecting the sterile field; hand cleanse, mask, gown and glove
  5. ME 3.4 Select and provide sedation and local analgesia, as appropriate
  6. ME 3.4 Handle sharps safely
  7. ME 3.4 Perform the procedure in a skilful and safe manner
  8. ME 3.4 Monitor patient comfort and safety, and adjust the procedure as needed
  9. COL 1.2 Communicate effectively with patient and/or assistant(s) during the procedure
  10. P 1.1 Work within personal limits, asking for assistance as needed
  11. COM 5.1 Document the procedure and outcome
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