Emily Anne Carpenter Rose
丁香诊所 急诊科
丁香诊所全科培训课程 18:当儿童患上成人常见疾病时

丁香诊所全科培训课程 18:当儿童患上成人常见疾病时
  • 静脉血栓形成
  • 肺栓塞
  • 卒中
  • 心肌梗死
  • 肥胖症

在丁香诊所「全科医生强化培训班」中,来自美国南加州大学医院的儿童急诊副教授 Emily Rose 与大家一起讨论《成人疾病在儿童中的表现》。

静脉血栓、肺栓塞、脑卒中以及心肌梗死,这几个成人常见病,也能发生于儿童。与成人相比,儿童血液中凝血酶更少,其诱因比如肥胖、糖尿病等更少。所以当这几种病发生时,儿童的临床表现、治疗以及结局与成人相比不同。

中央静脉置管是儿童静脉血栓最大诱因,常见于癌症儿童。大于 2/3 儿童深静脉血栓发生于左上肢。儿童静脉血栓于成人静脉血栓相比,缺乏性特异性诊断方法。在肺栓塞中,儿童的最终结局比成人更好,由于其更好的肺储备能力。

儿童脑卒中比脑肿瘤更常见,是儿童致死的前十病因之一。其临床表现与成人一样,比如局部肢体、意识的改变。但儿童鉴别诊断更多,如偏头疼、低血糖等。儿童脑卒中一半是出血性脑卒中,而成人大多是缺血性卒中。其危险因素与成人不一样,主要是动脉心病、感染、血液病等。其处理也存在差异,主要是肝素或阿司匹林治疗。如果能确诊存在血栓,可以用组织型纤溶酶治疗。

心肌梗死可以发生在任意年龄阶段。儿童心肌梗死主要发生于两种情况。一种是儿童有先天性血管异常,比如肺动脉冠状动脉狭窄;另一种是继发性动脉硬化,如川崎病、服用毒品、肥胖等。

虽然上述疾病会发生在儿童中,但采取适当治疗,儿童的预后更好。

本期丁香诊所「全科医生强化培训班」共96期,儿科相关课程还包括以下内容:

丁香诊所全科培训课程 18:当儿童患上成人常见疾病时

丁香诊所全科培训课程 19:儿童发热的诊断与治疗

丁香诊所全科培训课程 20:治疗儿童肥胖 减少肥胖并发症

丁香诊所全科培训课程 21:儿童骨科常见问题分析

丁香诊所全科培训课程 22:儿童呼吸道疾病治疗方法盘点

丁香诊所全科培训课程 23:儿童皮疹的诊断与治疗

丁香诊所全科培训课程 24:不容忽视 儿童轻型外伤的处理

丁香诊所全科培训课程 25:如何处理儿童烧伤

丁香诊所全科培训课程 26:如何处理儿童指部损伤

丁香诊所全科培训课程 27:2 类儿童中毒处理方式

丁香诊所全科培训课程 28:诊断儿童腹部常见病 全面考虑各类因素

更多精彩内容请点击此处观看丁香公开课全部课程。

封面图片来源:shutterstock 网站

Emily Anne Carpenter Rose

丁香诊所 急诊科

Emily Anne Carpenter Rose, 美国南加州大学医院儿童急诊副教授、主任。

MD, FAAP, FAAEM, FACEP

Education:
High School: Lincoln High School, Sioux Falls, SD,1995
College or University: Gordon College, Wenham, MA, Bachelor of Science(Biology), Summa Cum Laude, 1999
Jerusalem University College, Jerusalem, Israel, 1996, 1998
GraduateSchool: Gordon Conwell Theological Seminary, Hamilton, MA,(Religious Studies),1999-2000
MedicalSchool:Sanford School of Medicine of the University of South Dakota, Vermillion, SD, Medical Doctor, Magna Cum Laude, 2004
​Internship: Arrowhead Regional Medical Center (Transitional Year), Colton, CA, July2004–June2005
Residency: LAC + USC Medical Center (Emergency Medicine), Los Angeles, CA, July2005–June2008, Chief Resident, Emergency Medicine, LAC + USC, Medical Center, Los Angeles, 2007-2008
Fellowship: Loma Linda University Medical Center (Pediatric Emergency Medicine), Loma Linda, CA, July 2008–June 2010
Honors and Awards:
Faculty of the Year, Graduating Resident Award, Department of Emergency Medicine, LAC+USC Medical Center, Los Angeles, CA, 2013-2014
Faculty of the Year, Emergency Medicine Student Interest Group Award, Keck School of Medicine of the University of Southern California, 2014
Chief Resident Award, Emergency Medicine, LAC+USC Medical Center, Los Angeles, CA, 2007-2008
Transitional OB/GYN Resident of the Year, Arrowhead Regional Medical Center, Colton, 2005
Gerald H. & Jackie Lofgren Memorial Scholarship for Academic Achievement, University of South Dakota School of Medicine, Vermillion, SD, 2003-2004
Alma Carlson Scholarship for Academic Achievement, University of South Dakota School of Medicine, Vermillion, SD, 2002-2003
Ernest & Mina Walkes Scholarship for Academic Achievement, University of South Dakota School of Medicine, Vermillion, SD, 2001-2002
Graham Scholarship for Academic Excellence, Gordon Conwell Theological Seminary, Hamilton, MA, 1999-2000
Phi Alpha Chi Honors Society, Gordon College, Wenham, MA, 1999-present
Premedical Society Selected Member, Gordon College, Wenham, MA, 1996-1999
AJ Gordon Leadership Scholarship, Gordon College, Wenham, MA , 1997-1999
Music Leadership Scholarship, Gordon College, Wenham, MA, 1995-1999
Graduation Speech,「The True Meaning of Success」Lincoln High School, Sioux Falls, SD, 1995

Medical Licensure Number:
A93596, California, 2005-present

Board Certification:
Emergency Medicine, 2009
Pediatric Emergency Medicine, 2011

Professional Background:
Academic Appointments
Assistant Professor, Keck School of Medicine of USC, Clinical Emergency Medicine, Los Angeles, CA, 2010–present
Clinical Administrative Appointments
Interim Chief, Division of Pediatric Emergency Medicine, LAC+USC Department of Emergency Medicine, Los Angeles, CA, 5/2013-8/2013
Director, Keck School of Medicine/LAC+USC Medical Center, Pediatric Emergency Medicine Medical Student Selective, Los Angeles, CA, 2010-present
Coordinator, Pediatric Emergency Medicine Education, Emergency Medicine Residency, LAC+USC Medical Center, Los Angeles, CA, 6/2012-present
Coordinator, Emergency Medicine Education, Pediatric Residency, LAC+USC Medical Center, Los Angeles, CA, 6/2012-present
Track Leader, Pediatric Emergency Medicine, Emergency Medicine Residency, LAC+USC Medical Center, Los Angeles, CA, 11/2014-present
Specific Teaching Responsibilities
Instructor, ACLS, 2005-present
Instructor, PALS, 2008-present
Pediatric Simulation Lab Faculty, Emergency Medicine Student Interest Group (EMSIG), Intraosseous Access, Irvine, CA, 9/22/2012
Pediatric Simulation Lab Faculty,Resusciation Course, Intraosseous Access, Las Vegas, NV, 3/2010, 4/2012, 5/2013, 3/2014
Pediatric Simulation Lab Faculty, EMSIG, Intraosseous Access, LAC+USC Medical Center, Los Angeles, CA, 9/10/2011.
Pediatric Simulation Lab Faculty, EMSIG, Surgical Cricothyrotomy, LAC+USC Medical Center, Los Angeles, CA, 2/29/2012.
Pediatric Simulation Lab Faculty, Resusciation Course, Laryngeal Mask Airway and Bag-Valve Mask, Las Vegas, NV, 5/2013
Pediatric Simulation Lab Faculty, American College of Emergency Physicians Advanced Pediatric Assembly, Intraosseous Lines. New York, NY, 3/18/2014, 3/23/2015
Pediatric Simulation Lab Faculty,Resusciation Course, Central Venous Access, Las Vegas, NV, 3/2014
Pediatric Simulation and Procedure Course Director, APLS, PGY-3 Emergency Medicine Residency, LAC+USC Medical Center, Los Angeles, CA, 6/23/2014
Pediatric Procedure Lab (needle cricothyrotomy and umbilical lines), Department of Emergency Medicine Grand Rounds, LAC+USC Medical Center, 7/24/2014
Pediatric Simulation Lab Faculty, American College of Emergency Physicians Advanced Pediatric Assembly, LMA/Bougie/King/Foreign Body Alternative Airway Station, 3/23/2015

Other:
Emergency Department Attending Physician, Kaiser Permanente Bellflower Hospital, Bellflower, CA, 2007-2008
Emergency Department Attending Physician, Bakersfield Memorial Hospital, Bakersfield, CA, 2007-2008
Emergency Department Attending Physician, California Hospital Medical Center, Los Angeles, CA, 2008-2012
Emergency Department Attending Physician, LAC + USC Medical Center Department of Emergency Medicine, Los Angeles, CA, 2010–present
Urgent Care Attending Physician, LA County Jail, Los Angeles, CA, August 2013-present

Society Memberships:
Distinguished
Fellow, American Academy of Emergency Medicine, 2008-present
Fellow, American Academy of Pediatrics, 2011-present
Fellow, American College of Emergency Physicians, 2013-present
Professional
American Academy of Emergency Medicine (AAEM), 2006-present
American College of Emergency Physicians (ACEP), 2006-present
California Chapter, American College of Emergency Physicians (ACEP), 2009-present
Pediatric Section, American College of Emergency Physicians (ACEP), 2009-present
American Academy of Pediatrics (AAP), 2011-present
American Academy of Pediatrics, Emergency Medicine chapter, 2011-present

Service:
University/Other Committees
MD Evaluation and Recruitment Subcommittee, Keck School of Medicine of USC, Los Angeles, CA, 2012-2013, 2013-2014, 2014-2015
Mentor, Medical Students, Keck School of Medicine of USC, Los Angeles, CA, (advisor for EM-interested students and write SLOEs for 5-10 students/year), 2010-present
Mentor, American Medical Women’s Association, Keck School of Medicine (mentor 2 female medical students per year), 2014-present
Mentor, Residents, Emergency Medicine Residency Program, LAC+USC Department of Emergency Medicine (mentor 1-2 new residents per year and continue mentoring relationships with residents after graduation), 2011-present
Lecture Coordinator, Pediatric Spotlight weekly Pediatric Emergency Medicine lectures for nurses, LAC+USC Medical Center, 1/2011-present
Ouchless ED, coordinator of『ouchless』medications, devices, protocols and child-friendly activities for the Pediatric Emergency Department, LAC+USC Medical Center 10/2011-12/2012
Instructor, Introduction to Clinical Skills Course, Keck School of Medicine, April 2012, 2013, 2014, 2015
Customer Service Workgroup, Emergency MedicinePhysician Representative, July 2012-July 2013
Interqual Physician Secondary Reviewer, August 2012-present
Graduate Medical Education Committee, Pediatric Division Representative, LAC+USC Emergency Medicine Residency Program, October 2012-present
Peer Review Committee, February 2013-present
Faculty Development Committee, Department of Emergency Medicine, LAC+USC Medical Center, August 2013-present
National Committees
American College of Emergency Physicians (ACEP) Pediatric Committee, May 2014-present. (Serve on at least two objectives per year)
Editorships
Section Editor, Pediatric Infectious Disease, PEMSoft, 2012-2014 (55 chapters)
Journal Reviews
The Journal of Emergency Medicine (review approximately 8 submissions/year)
Pediatric Emergency Practice
Other
Sessions Chaired
Increasing the role of the two star. 2011 faculty retreat, LAC + USC Medical Center Department of Emergency Medicine, Los Angeles, CA, 8/2012-9/2012.
Course Director. Pediatric Emergency Medicine Foundation. (HIPPO
EM Pediatric Emergency Medicine Foundation online course; producers [Mel Herbert, Paul Jhun and Aaron Bright]) Los Angeles, CA, 4-6/2014
Course Director. APLS. Pediatric Emergency Medicine Review. Simulation, Procedure Lab and case-based discussion. PGY-4, Emergency Medicine Residency, LAC+USC Medical Center; June,2014, 2015

Research Activities:
Major Areas of Research Interest
Pediatric Trauma. Resuscitation. Medical Education
Research in Progress
The presentation of deep venous thrombosis or venour thromboembolism to the emergency department and the incidence of prothrombotic disorders among these patients.
Buffered versus non-buffered lidocaine use with the J-tip device: Does it matter?
MRI for pediatric acute appendicitis: is CT of the past?
The Flipped Classroom for Medical Education.

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