Primary Goals for this Rotation
Asthma. Diagnose and manage patients with asthma
Identify the signs, symptoms, and pathophysiology of asthma, and
differentiate asthma from other causes of cough, wheezing, shortness of
breath, and exercise intolerance.
Identify associated diseases or co-morbid conditions related to asthma (e.g.
GER, allergic rhinitis, etc.).
Identify triggers that exacerbate a patient’s asthma (environmental,
seasonal, infectious) and provide counseling about avoidance where feasible.
Educate a patient and family about all aspects of asthma, including course
of disease, quality of life, risk factors for sudden death, strategies to
improve adherence to treatment, trigger avoidance, symptom recognition and
monitoring, asthma action plans, medications and delivery systems, and
seeking professional medical care.
Identify the indicators for an allergy or pulmonary referral of a child with
asthma.
Prevention, Counseling and Screening
Understand the role of the pediatrician in preventing pulmonary disease, and
in counseling and screening individuals at risk for these diseases.
Normal Versus Abnormal
Distinguish normal from pathological pulmonary conditions.
Differentiate normal variations in chest wall anatomy (e.g., pectus
excavatum) from those which impair ventilation (e.g., scoliosis).
Identify system conditions that may present with respiratory symptoms or
lead to pulmonary disease, including swallowing dysfunction,
immunodeficiency, and restrictive orthopedic conditions.
Identify indications and limitations of clinical and laboratory tests used
to identify pulmonary-based disease and respiratory failure. Interpret the
following tests: chest x-ray, pulmonary function test reports (e.g.,
spirometry and lung volume determinations), polysomnography reports, pulse
oximetry, blood gas determination, sweat chloride testing, exercise
challenge and bronchial provocation studies.
Undifferentiated Signs and Symptoms
Evaluate, treat, and/or refer patients presenting with signs and symptoms
that suggest an abnormality of the respiratory system.
Chronic Lung Disease (CLD)
Understand the general pediatrician's role in the management of
bronchopulmonary dysplasia in children.
Collaborate with a pulmonologist to execute a respiratory management plan as
part of the coordination of care for a child with chronic lung disease.
Identify indicators that signify a worsening pulmonary condition in a child
with CLD and may require a pulmonary referral and re-evaluation.
Cystic Fibrosis
Understand the general pediatrician's role in the management of cystic
fibrosis.
Participate in development and implementation of a coordinated pulmonary and
nutritional treatment plan for a patient with cystic fibrosis, including
recognition and treatment of acute episodic illnesses, nutritional
deficiencies, intestinal obstruction, and psychosocial issues. Discuss the
multidisciplinary approach to cystic fibrosis care and the role of the
general pediatrician.
Identify indicators that signify an exacerbation of pulmonary symptoms.
Provide appropriate initial treatment and referral to a specialty center for
further evaluation and treatment.
Maintenance of Airway Patency and Oxygenation
Recognize and manage upper airway obstruction and desaturation.
BRONX-LEBANON HOSPITAL CENTER
