Paediatric Emergency Medicine Course (PEMC)
Our mission: “Aim to educate frontline health workers in the emergency management of critically ill
children in less than ideal circumstances”
Rationale: Many international emergency courses assume access to first world facilities, staffing and
resources and this limits their applicability to low-resource settings. The Paediatric Emergency
Medicine Course (PEMC) is designed to bring simple yet effective, evidence-based practices and
high-quality emergency care to under-resourced, overwhelmed settings.
Background: The first PEMC was conducted in 1999 under the auspices of the Indian Society of
Critical Care Medicine (ISCCM). The course was based on the lessons learned over the last decade
from resuscitating a large volume of critically ill children and training over 1500 residents in this subspecialty. Peer reviewed by more than 100 paediatricians and sub-specialists in paediatric
emergency medicine since 1999, the modules were fine tuned to addressing the commonest pearls
and pitfalls in acute care medicine. A unique feature of this course are the video clips and photos
taken during active resuscitation. The PEMC has become a must attend course for busy emergency
clinicians caring for acutely ill children in resource limited settings.
Course Overview:
1) Formatted into modules, the delegate is taken through the steps of recognition and resuscitation
in critical illness in settings without immediate access to invasive monitoring, blood gas analysis, and
universal access to mechanical ventilation.
2) Step wise management of common emergencies such as: life-threatening asthma, stridor,
circulatory shock, coma, status epilepticus etc. using current evidence based protocols modified for
the low resource/high acuity context.
3) Skill stations with demonstration of procedures and equipment such as bag-valve mask
ventilation, laryngeal mask airway insertion, intraosseous line placement etc.
4) A colourful and up dated manual providing state of the art information on time sensitive goal
directed management in ‘the golden hour’.
Note: This is a practical clinical emergency course but not a cardiopulmonary resuscitation (CPR)
course.
Course Materials:

PEMC Course manual (*see review below – new edition published 2013 [not essential if
space limited – see below – pls remove this note if removed])

Western Cape PEM Guidelines Book
Facilitators:
A multi-disciplinary team of international and local experts including: PEM, EM and Paediatric
specialists, senior nurse trainers and paramedic trainers. Led by Dr. Indumathy Santhanam (India)
and Dr. Baljit Cheema (S Africa).
Participants:
This course is suitable for doctors, nurses and paramedics who are working with children in
emergency settings. The focus will be mainly on clinical assessment and management in emergency
centres but the topics covered and skills taught have high relevance to both emergency nursing and
paramedics clinical care.
There is a limit of 48 participants. We anticipate that the places will be snapped up very quickly – so
please book early to avoid disappointment.
Venue:
Johnson & Johnson Education Centre, Red Cross war Memorial Children’s Hospital, Klipfontein Road,
Rondebosch, Cape Town
Programme:
8:00 am to 08:30 am
Registration & tea/coffee
8:30 am to 08:45
Welcome & Introduction
8:45 am to 9:15 am
Recognition of sick child
9:15 am to 9:30 am
Stridor
9:30 am to 10:00 am
Wheeze & Asthma
10:00 am to 10:20 am
Break
10:20 am to 10:50 am
Cough & Fast breathing
10:50 am to 11:15 am
Status epilepticus
11:15 am to 12:15 pm
Bag-valve mask
Practical Stations
LMA
12:15 am to 12:45 pm
Lunch
12:45 pm to 13:15 pm
Shock
13:15 pm to 13:45 pm
Dehydration
13:45 pm to 14:15 pm
Fever
14:15 pm to 14:30 pm
Break
IOL Insertion – practical station
14:30 pm to 16:30 pm
Shock cases - groupwork
Groupwork & Practical
Rapid rehydration – practical station
Stations
Fever cases - groupwork
16:30 pm to 16:45 pm
Close
(Note: this programme is a draft & may be subject to amendment)
Summary: This is a very practical, focussed course intended to help doctors, nurses and paramedics
recognise and manage common paediatric medical emergencies.
*PEMC Manual - Book Review
By Andrew C. Argent in the Journal of Paediatric Critical Care Medicine 2009 Vol. 10, No. 2
There is a need for educational material about the effective management of critically ill children
across the world. Although many books are available, they are often orientated to pathology,
systems, resources, skills, and structures that are routinely available in the richer countries of the
world. Most critically ill children present to healthcare facilities in countries where conditions may
be different, and it is essential that resources are developed to assist healthcare workers inthese
environments. This book provides a wonderful introduction to the practice of pediatric emergency
and critical care medicine in India particularly, but will be useful to people in many other parts of the
world.
The book is made up of 31 chapters (with well-known contributors from several regions of India)
ranging from an introductory overview of critically ill children through chapters on respiratory
distress and shock, to comments on the organization of pediatric emergency services. It is directed
at people working in pediatric emergency medicine and covers a wide range of pediatric and surgical
emergencies. Specific work stations are provided regarding practical procedures such as chest tube
placement and thoracocentesis, pericardiocentesis, laryngeal mask airway placement, pulse
oximetry, nebulizer therapy, and central venous access. Despite a number of contributors, the
coherence of the book has been well maintained.
The text is generally clear and readily understandable and richly illustrated with photographs,
illustrations, tables, and flow charts. There is an underlying assumption that staff in the emergency
department will be required to initiate and continue therapy for some time, possibly in the absence
of pediatric intensive care services. As a result information is provided at a range of levels from the
basic assessment of critically ill or injured children, through to detailed discussion of which particular
inotropic agents should be selected in specific circumstances. It may have been more effective to
aim the text at a more focused audience, but the current text has material of interest to people at
many levels in the health services.
This book is a useful addition to the resources for pediatric emergency care in countries with limited
resources. It will be of interest to anyone working in pediatric emergency or critical care medicine,
but particularly for those looking for practical guidelines on management of critically ill children in
less than ideal circumstances.
Andrew C. Argent, MB, BCh, MMed(Paeds), FCPaeds(SA), FRCPCH(UK)
Red Cross War Memorial,Children’s Hospital,
University of Cape Town,
Cape Town,
South Africa
DOI: 10.1097/PCC.0b013e318198a674