A Pediatric Emergency Nurse is a registered nurse who provides urgent and emergent nursing care to pediatric patients and families. Nursing care includes providing direct care, health care facilitation, education, and advocacy for patients and families.

The following concepts are integrated throughout the examination, appropriate to the stated task:

Approximately 7% of the examination will require only recall on the part of the candidate, 55% will require application of knowledge, and 38% will require analysis of pediatric emergency situations.

Triage (16 Items)
A. Emergency Intake

Perform visual assessment (sick vs. not sick)
Perform secondary survey (focused assessment)
Obtain detailed medical and surgical history
Assess psychosocial status and risk for violence
Customize the assessment for children with special needs (i.e., developmental diversity)
Identify caregivers’ perception of child’s baseline
Identify suspected abuse, neglect, maltreatment

Perform age appropriate assessment of pain

Identify primary caregiver
Assess family functioning and dynamics
Assess family coping strategies and support systems

Patient and Family Care: Managing Technical Skills (18 items)
A. Technical Skills

Intraosseous access
Cardioversion
Defibrillation
Cardiac pacing
Peripheral IV access
Central IV access (including PICC, venous access ports)
Invasive hemodynamic monitoring (e.g., central venous pressure, arterial lines)
Incision and drainage
Dressings
Wound closure
Intracranial pressure monitoring
Chest tubes
Nasopharyngeal wash (e.g., RSV)
Specimen collection
Enteral tubes (e.g., nasogastric, orogastric, PEG)
Chemical or biological decontamination
Capnography
Ventilator use
BiPAP, CPAP
Removal of an injured child from a child safety seat
Spinal immobilization
Holding for procedures
12-lead ECG
Airway adjunct
Infant warmer

Patient and Family Care: Medical emergencies (42 items)
A. Airway

Mechanical obstruction (e.g., foreign body)
Pathophysiologic (e.g., anaphylaxis, infectious)
Congenital (e.g., stenosis, malacia)

Mechanical (e.g., pneumothorax, foreign body, embolism)
Pathophysiological (e.g., bronchiolitis, reactive airway disease, pneumonia)
Congenital (e.g., chronic lung disease)

Mechanical (e.g., tamponade, tension pneumothorax)
Pathophysiologic (e.g., shock, rhythm disturbances, congestive heart failure, infections)
Congenital (e.g., aortic stenosis)

Mechanical (e.g., shunt malfunction, tumors)
Pathophysiologic (e.g., seizures, infections, stroke, headache)
Congenital (e.g., hydrocephalus, arteriovenous malformation)

Mechanical (e.g., obstructions, intussusception)
Pathophysiologic (e.g., infections, necrotizing enterocolitis, fluid-electrolyte imbalance)
Congenital (e.g., tracheoesophageal fistula,)
Nutrition (e.g., failure to thrive, formula intolerance, obesity)

Mechanical (e.g., stricture, ovarian cyst)
Pathophysiologic (e.g., urinary tract infections, renal failure, sexually transmitted infections)
Congenital (e.g., urethral valve disease)

Pathophysiologic (e.g., infections, necrotizing enterocolitis, fluid-electrolyte imbalance, jaundice, thermoregulation)
Congenital (e.g., ductal dependent lesions, tracheoesophageal fistula, obstructive uropathy) Nutritional deficits
Care of the newly born (e.g., resuscitation following delivery)

Heat and cold
Bites and stings
Toxic exposures (e.g., nuclear, chemical, radiologic, biologic)
Ingestions (e.g., intentional and unintentional)

Hematology (e.g., sickle cell, bleeding or clotting disorders)
Oncology (e.g., fever and neutropenia, tumor lysis syndrome)
Endocrine (e.g., congenital adrenal disorders, glucose disturbance)
Genetic and metabolic
Dermatology (e.g., rashes, infections)
Eyes, ears, nose, and throat (e.g., hyphema)

Patient and Family Care: Surgical, Trauma, and Procedural Sedation (27 items)
A. Surgical Emergencies

Gastrointestinal (e.g., acute abdomen, appendicitis, malrotation/volvulus, strangulated hernia, pyloric stenosis)
Genitourinary and reproductive (e.g., testicular torsion, ectopic pregnancy)
Musculoskeletal (e.g., compartment syndrome, slipped capital femoral epiphysis (SCFE))
Postoperative hemorrhage (e.g., tonsillectomy)
Neurological (e.g., shunt failure, herniation syndrome)

Burns (e.g., heat, electrical, inhalation)
Near drowning
Neurological trauma
Musculoskeletal trauma (e.g., fractures, lacerations, joint dislocations, sprains and strains)
Cardiothoracic trauma (e.g., pneumothorax, hemothorax)
Abdominal trauma
Maxillofacial and dental trauma
Multi-system trauma

Patient monitoring
Essential equipment (e.g., electrocardiogram, blood pressure, SPO2, oxygen, airway)
Medications and reversal agents
Consent

Patient and Family Care: Psychological and Maltreatment Emergencies (11 items)
A. Psychological Emergencies

Suicidal ideations/attempts
Homicidal ideations/attempts
Acute psychosis
Aggressive behavior
Substance abuse
Post-traumatic stress disorder

Abuse (e.g., shaken impact syndrome, Munchausen syndrome by proxy)
Neglect
Emotional abuse
Sexual abuse (including sexual assault)

7. Legal and Professional Issues (7 items)
A. Legal Issues

Ensure that informed consent has been obtained
Ensure preservation of forensic evidence and chain of custody
Comply with EMTALA regulations

Resolve conflicts with family members
Facilitate in critical incident stress management (debriefing)
Promote safety and health/wellness in the community