Radiation injuries and illnesses in pediatric emergency medicine

Radiation Injury Presenting to the Emergency Department: A Case Report

Radiation injuries are closer to home than expected as radioactive sources are common in daily life. Our case study illustrates a case of radiation burns to the hand which presented about two weeks later to the emergency department after accidental exposure to an industrial radiation source. A 45-year old Chinese man presented 17 days later after being exposed accidentally to iridium-192 source at 43 curies. He subsequently suffered burns that required multiple operations to treat. The diagnosis of patients who present early after exposure with no clinical signs will likely pose a challenge for the emergency medicine clinician as radiation burns take time to manifest and may present days to weeks after radiation exposure.

Impact of an educational intervention on residents' knowledge of pediatric disaster medicine

BACKGROUND

Globally, natural and created events have underscored the vulnerability of children in disasters. There is an unmet need for a standardized pediatric disaster medicine (PDM) curriculum.

OBJECTIVE

To create and implement a PDM course, measure course efficacy, and assess residents' attitudes toward and experience in disaster medicine.

DESIGN/METHODS

An educational intervention was conducted for pediatric and emergency medicine residents at a tertiary care teaching hospital. Participants completed a precourse survey of PDM attitudes and experience. Paired t tests were used to compare pretest, immediate posttest, and delayed posttest scores. Test performance was assessed by resident type and postgraduate year. A postcourse survey gauged reaction to the course and interest in further PDM training.

RESULTS

Among the participants, 11 residents (9.4%) have treated disaster victims, and 5 (4.3%) had formal disaster medicine education. Most (83%) felt PDM is an important part of their training. Seventy-five eligible residents (64.6%) completed the intervention. Pairwise comparison of scores showed a mean improvement in scores of 24.5% immediately after taking the course (95% confidence interval, 22.9%-30.1%; P < 0.001). Two months later, residents scored a mean of 69.0% for the delayed posttest, with a retained improvement in scores (18.3%; 95% confidence interval, 14.3%-22.3%; P < 0.001). Residents preferred future PDM exercises to additional didactic training (72.0% vs. 32.7%; P < 0.001%).

CONCLUSIONS

Residents who complete this curriculum increase their knowledge of PDM with moderate retention of information. Most residents lack PDM training, believe it is important, and request disaster-training exercises.